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The JOURNAL 


Iowa State Medical Society 


• iKiiiimmiiHiiii 





VoL. XXXV Des Moines, Iowa, January, 1945 No. 1 


THE MANAGEMENT OF ABORTIONS* 
Willis E. Brown, M.D., Iowa Cityf 

To present a coordinated discussion of this sub- 
ject would require consideration of all varieties of 
abortion. Any complete discussion of the subject 
obviously is impossible in the space allotted for 
this presentation. We have, therefore, reduced to 
outline form features of the various types of abor- 
tion. and plan to consider in detail the more impor- 
tant problems encountered. Any classification of 
abortion would include the following types : Ha- 
bitual. threatened and inevitable, missed, molar, 
complete, and incomplete abortions. 

HABITUAL ABORTION 

Habitual abortion is not a common clinical en- 
tity but may upon occasion require medical atten- 
tion. It is generally diagnosed in a patient who 
has had more than two spontaneous sequential 
abortions where no obvious cause can be found. 
Such abortions are due primarily to abnormalities 
of the embryo in which both the husband and wife 
share responsibility. The treatment of such pa- 
tients obviously should begin before conception 
and is designed to improve the quality of the germ 
cells that wall contribute to the ovum. As a gen- 
eral rule, systemic and metabolic considerations are 
more important than endocrine, and, except for 
thyroid which may be used as a general metabolic 
stimulant, endocrine therapy plays a minor role in 
the management of these patients. If a normal 
embryo can be obtained, treatment during preg- 
nancy is relatively unimportant. Bed rest and 
thyroid are recommended until the pregnancy is 
well into the second trimester. 

THREATENED AND INEVITABLE ABORTION 

Threatened abortion is a common clinical en- 
tity. Since we are unable to predict the outcome 
of any threatened abortion, it has been impossible 
to catalog or classify tlijs clinical condition satis- 
factorily. Any early pregnancy which presents 

♦Presented before the Ninety-Third Annual Session. Iowa State 
Medical Society, Des Moines. April 20 and 21, 1944. 

fFrom the Department of Obstetrics and Gynecology, State Uni- 
versity of Iowa College of Medicine. 


bleeding and/or cramps is considered as a threat- 
ened abortion. These symptoms are due to a 
variety of causes, the most common of which is 
the continuance of menses around a pregnancy. 
These patients do well without treatment. If the 
symptoms become more serious and an abortion 
occurs, this is usually due to an abnormal embryo. 
Systemic diseases will occasionally interfere with 
the development of pregnancy. We have all seen 
patients in whom emotional and/ or physical shock 
or ti'auma have precipitated abortion. Uterine dis- 
orders and irritability are given a high place in the 
etiologic considerations of this condition ; yet we 
believe they are relatively unimportant. When the 
uterus is at fault, it is more apt to be due to a 
failure of conversion of the secretory endometrium 
to decidua. We believe this conversion to be en- 
tirely the function of the conceptus and its grow- 
ing trophoblast, and not a function of progester- 
one. ' If, progesterone plays any role in early preg- 
nancy, it is in the preparation of the endometrium 
for implantation, and perhaps in the support of the 
converted decidua. 

Utei'ine cramps' and bleeding are the signs of 
abnormality; not the cause. Do not forget that 
many patients presenting a history of threatened 
abortion have had an attempted induction. 

Fortunately, most patients with threatened abor- 
tion go on uneventfully to term, in which case 
any management which is prescribed will be effec- 
tive. This accounts for the great variety of reme- 
dies for this condition. Most of the medicaments 
commonly recommended for threatened abortion, 
such as wheat germ oil, belladonna, and progester- 
one, are given for the benefit of the family and 
to be “doing something.” Bed rest is probably the 
most significant advice we can give these patients. 
The addition of thyroid as a nonspecific meta- 
bolic stimulant and possibly to assist in the main- 
tenance of the decidua may be of some value. 

Threatened abortion offers no real problem as 
such. The pregnancy will either go to term de- 
spite our therapy or become an inevitable abortion 
and terminate itself. The only clinical problem 


9 


Journal of Iowa Statf Mfdical Society 


January. 1945 


is the recognition of what constitutes an inevitaljlc 
al)ortion, for it is useless to continue a regimen for 
threatened abortion if the patient has lost all pos- 
sibility of carrying the pregnancy to a fruitful 
termination. 4'he following factors may he useful 
in establishing the diagnosis of inevitable abor- 
tion: A threatened abortion which shows (1) ef- 
facement of the cervix, (2) more than two centi- 
meters of cervical dilatation, (3) rupture of the 
membranes, (4) bleeding for more than ten days, 
(5) the persistence of cramps despite morphine, 
and (6) signs of fetal death such as regressive 
breast changes, absence of a previously heard fetal 
heart heat, and a negative biologic test. If two or 
three of these clinical observations are present, 
one should abandon treatment for threatened abor- 
tion and empty the uterus by the most conservative 
means at one’s disposal. Ordinarily this would be 
by the use of an oxytocic. If this fails, the me- 
chanical evacuation of the uterus by curet or ovum 
forceps is in order. 

Do not persist too long in the medical manage- 
ment of threatened abortion. Most of these em- 
bryos are abnormal and sooner or later you will 
have the misfortune of prolonging a grossly abnor- 
mal pregnancy to the patient’s disadvantage and 
your own embarrassment. Threatened abortion 
and inevitable abortion ofifer the same complication 
as any abortion ; namely, they may become incom- 
plete requiring further treatment. 

MOLAR ABORTION 

Molar abortion is a less common clinical entity, 
but because of its grave possibilities it warrants 
at least a passing comment. It is always due to 
a diseased ovum. 

The diagnosis of molar pregnancy is not easy 
but should be suspected in a patient with a history 
of pregnancy and an attempted or partial abortion. 
The uterus is usually disproportionately enlarged 
for the probable duration of pregnancy. There are 
no signs of fetal life or development as deter- 
mined by palpation or x-ray examination. The 
biologic test is usually positive, although occasion- 
ally it may be negative. Frequently the patient 
will pass one or more hydatids which confirms the 
diagnosis. Pelvic examination reveals the cervix 
to be dilated. The vaginal discharge is apt to be 
bloody fluid rather than blood. 

The management of molar abortion has been 
standardized. The uterus should be emptied by 
the most conservative procedure, which is usually 
by an oxytocic. Occasionally it will be necessary 
to evacuate tbe uterus by curettement or by hys- 
terotomy. These patients should be followed for 
approximately one year with biologic tests. If the 
test remains negative during this period, the pa- 


tient can be considered free of the risk of malig- 
nancy. 

CO.MPLETE ABORTION 

Com])lcte abortions may he divided into those 
which are infected and those which are nonin- 
fected. If the patient shows evidence of infection 
it usually (not always) signifies that the abortion 
was induced. Complete abortions are usually found 
before the sixth week and after the twelfth week 
of pregnancy. This condition prevails because of 
the development of the placenta. Prior to six 
weeks the ovum lies free in a Idood lake within 
the decidua and an abortion is apt to be cast com- 
pletel}^ together with fragments of the decidua. 
Pjetween the sixth and the twelfth weeks of jireg- 
nancy, the chorionic trophohlast is invading the 
decidua for purposes of nourishing and anchoring 
the pregnancy. This invasion progresses at irregu- 
lar rates so that portions of the trophohlast may 
penetrate deeply into the decidua basalis and thus 
be left behind during the abortion. After twelve 
weeks the placenta has essentially matured and its 
separation follows the usual mechanism seen at 
term. 

Examination of the material passed at a com- 
plete abortion will usually reveal a fairly complete 
ovular specimen. The uterus is firmly contracted 
and not bleeding profusely. These findings estab- 
lish the diagnosis of a completed abortion. ■ If the 
lochia is normal and there is no tenderness or pain 
in the pelvis, the temperature is normal, and the 
white blood count is under 15,000. we may as- 
sume a diagnosis of noninfected complete abor- 
tion. Such a patient requires no special therapy, 
and a few days of bed rest is all that need be 
advised. 

On the other hand, if the lochia is' foul and 
there is pelvic pain or tenderness, fever and tachy- 
cardia, and the white blood count is over 15.000, 
the diagnosis of infected complete abortion is in 
order. Since the uterus is empty, the management 
is directed entirely to the control of infection. 
Intra-uterine manipulation is never indicated. 
Treatment should be directed to confining infec- 
tion to the pelvis by the use of bed rest, semi- 
Fowler’s position, intravenous fluids, sedatives, 
and the avoidance of cathartics and enemas. The 
patient should be supported by small transfusions 
of 200 to 400 cubic centimeters of blood every 
twenty-four to forty-eight hours : in the presence 
of anemia, the first transfusion should be 400 to 
600 cubic centimeters of blood. If bacteriologic 
culture of the genital infection is possible, appro- 
priate chemotherapy should be started. In the ab- 
sence of such assistance, sulfathiazole or sulfadia- 
zine may be employed. The drug should be pushed 


THE MANAGEMENT OF ABORTIONS 


VOL . XXXV , No . 1 


Journal of Iowa State Medical Society 


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JouRNAr. OF Iowa State Medical Society 


January, 1945 


to the (levelopnient of an a(lc(|uate lilood level 
which should he maintained at least three days 
after the temperature has become normal. 

'fhe patient should be watched carefully and 
examined daily for evidence of toxic reactions to 
the sulfa drugs, for the development of pelvic or 
metastatic abscesses, and the presence of pelvic or 
femoral thrombophlebitis. These complications 
should be handled by the recognized methods. For- 
tunately, the mortality rate of infected complete 
abortion is low. Since we have abandoned intra- 
uterine manipulation and adopted the free use of 
transfusions and sulfa drugs, the mortality is 
chiefly a function of the duration and extent of 
the infection at the time the patient is first seen. 
The chief late complications of infected abortion 
are sterility and pelvic cellulitis, and these fortu- 
nately are not too common. 

incomplete abortion 

The management of incomplete abortion has 
offered more clinical difficulty than any other com- 
plication of pregnancy. More friendships have 
been broken and bitter epithets hurled in discus- 
sion of incomplete abortion than almost any other 
similar condition. In general, there are two oppos- 
ing camps each steadfastly supporting its own 
philosophy and violently opposing any compro- 
mise. One grouji maintains that the uterus should 
not be invaded, and the other that it should be 
cleaned out immediately. Both groups have pre- 
sented statistical evidence to support their points 
of view. Each group is adamant in the establish- 
ment of its own philosophy. Since both groups 
are able to demonstrate by statistical analyses al- 
most exactly the same percentage of good results, 
it seems entirely possible that both methods have 
something- to contribute in the management of in- 
complete abortion. If the good points of both 
schools of treatment could be recognized and ju- 
diciously used, would not our patients profit there- 
by ? 

Taussig, in his monograph on abortion says, 
“Tbe question at issue as I see it is not whether 
active treatment is preferable to expectant or con- 
servative treatment, but when active treatment is 
preferable and when the expectant or conservative 
measures should be employed.” 

In the chart we have tried to set up the condi- 
tions under which it seems justifiable to employ 
one or the other form of therapy. Incomplete 
abortion may be divided into three groups : those 
which are not infected, those which are potentially 
infected, and those which are infected. They may 
be sharply differentiated in most cases. 

An incomplete abortion is recognized by the 
presence of a soft boggy uterus, and the persist- 


ence of bleeding in an aborted pregnancy between 
six and twelve weeks of gestation. If such a pa- 
tient presents a normal temperature ( not over 99 
degrees), a normal white count (under 15,000), 
no pelvic tenderness or pain, and the symptoms 
are less than twenty-four hours old, the abortion 
may be classified as noninfected and incomplete. 
4'liese abortions may be spontaneous or induced. 

A potentially infected abortion presents the same 
clinical picture with two exceptions. It is usually 
an induced abortion and it is more than twenty- 
four hours old. 

The noninfected patient should be managed by 
tbe prompt emptying of the uterus by an oxytocic. 
A short time after giving the oxytocic, the cervix 
should be visualized under antiseptic technic and 
any fragments presenting at the os should be ex- 
tracted. If bleeding persists after a reasonable 
attempt at chemical emptying of the uterus, the 
uterus should be evacuated by a dull curet or ovum 
forceps. • 

Tbe patient should receive several blood trans- 
fusions, be placed at bed rest under oxytocics, and 
given expectant treatment as employed for the 
noninfected complete abortion. The prognosis in 
this group of patients is good and infection is 
uncommon. 

There is no magic in twenty-four hours over 
twenty-five or twenty-six, yet experien^ has 
taught that to deviate from the rule of twenty-four 
hours is to invite a rapidly rising complication rate. 
Incomplete abortion of more than twenty-four 
hours’ duration, but in which the evidence of in- 
fection is lacking, should be considered as- “po- 
tentially infected.” The uteri in these patients 
should be stimulated by oxytocics to empty spon- 
taneously ; and under antiseptic technic, cervical 
fragments may be extracted with safety. Except 
for exsanguinating hemorrhage, the uterus should 
not be invaded until after two days without fever. 
If fever develops during this time the case should 
be classified as an infected incomplete abortion. 
The prognosis in the potentially infected group is 
unpredictable for it depends on whether or not the 
patient is infected at the time when first seen. 
The case will become either a noninfected incom- 
plete abortion to be handled as indicated with a 
good prognosis, or an infected incomplete abortion. 

The infected incomplete abortion is almost al- 
ways criminally induced. It may appear at any 
stage of pregnancy. Examination reveals a boggy, 
bleeding uterus with a foul lochia; there is pelvic 
pain and tenderness. The patient presents fever, 
tachycardia, leukocytosis, and considerable tox- 
icity and prostration. If the abortion has occurred 
sometime previously there may also be extensive 
pelvic exudates or pelvic abscesses. The manage- 


\*0L. XXXV, No. 1 


Journal of Iowa State ^Medical Society 


5 


ment of this condition is well standardized. Since 
the infection is extra-uterine, our obligation is to 
treat the infection disregarding the uterus. In the 
presence of infection one should never invade or 
stimulate the uterus except for exsanguinating 
hemorrhage. The infection should be treated as 
indicated under complete infected abortion : sup- 
portive treatment, transfusions, sulfa therapy, with 
a careful watch for toxic and metastatic processes. 
X”ote the absence of oxytocics in the treatment of 
these patients. 

As the patient gains control of the infection, 
the fever and clinical signs of infection will sub- 
side. After five days of normal temperature the 
uterus may be evacuated mechanically if clinically 
indicated. The complications of infected incom- 
plete abortion are sepsis, metastatic and pelvic ab- 
scesses, salpingitis, and pelvic thrombophlebitis. 
These complications should be handled by the usual 
regimens. These patients are frequently left with 
chronic pelvic infection and sterility. 

SUMMARY 

In summary, we should like to point out that 
in the care of abortions, there are only two condi- 
tions where confusion is apt to develop, and in 
which the physician must exercise precise judg- 
ment. How long should we continue treatment for 
■threatened abortion, and how can we determine 
when a threatened abortion has become inevitable? 
The signs and symptoms of inevitable abortion are 
not easily recognized, but if more than two of the 
listed criteria are present the abortion should be 
considered inevitable. Do not complicate nature’s 
attempts to expel an abnormal pregnancy by inter- 
fering too long. 

The second point in which careful judgment is 
required is in the differential diagnosis of the in- 
complete abortion group. Misjudging the situa- 
tion and applying the treatment for the noninfected 
abortion to an infected patient will greatly increase 
the morbidity and mortality. 

If medicine has any claim as a science and an 
art, it is on the basis of our ability to individualize 
therapy rather than to insist on routinization of 
clinical syndromes under one form of treatment. 
Surely this applies to the management of abortions. 
Our success in the management of this complica- 
tion of pregnancy is directly related to our ability 
to differentiate clinically the various types of abor- 
tion and to institute appropriate therapy. 

Discussion 

Member: I should like to ask Dr. Br(^vn about the 
use of plasma in the country, where blood would not 
be available in cases of abortion, in instances in 
which transfusion would be indicated. 


Chairman Plass: May we specify that? Do you 
mean the infected abortion or the woman suffering 
from shock? 

Member: In any cases in which transfusion is con- 
sidered and blood is not available but plasma is. I 
wondered what his idea was about the use of plasma 
there. 

Dr. Brown: That question is not easy to answer 
unless you consider, briefly, the function of the 
transfusion. One can say, in general, the function 
of transfusion is threefold: to combat shock, to con- 
trol the infection, and to replace blood. 

In the replacement of blood, fluids, and electrolyte 
loss these patients are benefited by the use of any 
form of intravenous fiuid. Blood occasionally is not 
available, although with modern transportation and 
Red Cross banks, it is becoming increasingly avail- 
able. For the patient in shock, plasma has many 
advantages and one can also use acacia. Intravenous 
glucose should be given while the plasma or blood 
is being- obtained and prepared. 

However in most of those patients, except those 
in profound shock, plasma offers little more than 
any other fluid. 

The second function of using blood is in its sup- 
port of, and in combatting infection. In this group 
of conditions, plasma apparently offers very little. 
It supplies only the protein elements and, as far as 
we can determine, the opsonic and phagocytic factors 
are not present. 

For the replacement of blood, only transfusions are 
immediately effective. Iron and a high protein diet 
will enable most patients to regenerate their own 
blood. 

Thus, plasma as such would have value only as a 
fluid replacement element for the support of a failing 
circulation. I would not expect it to be of much 
value in combatting infection or replacing blood. 

Chahmian Plass: Obviously the use of blood in the 
combatting of infection is not an emergency proce- 
dure. I mean you can do that tomorrow or next day 
and still get good effect. 

Member: I should like to ask Dr. Brown to elab- 
orate a little more on pre-pregnancy treatment of 
habitual abortion. 

Dr. Brown: That is a real order. To try to make 
it as concise as I can, first I should define it. Habit- 
ual abortion is said to exist in a patient who pre- 
sents two sequential abortions ■without obvious cause. 
The occurrence of two abortions in any woman is 
not uncommon, but this is two sequential abortions 
without ob-vious cause. These abortions are due, in 
general, to one of two factors: either abnormalities 
of the embryo or diseases of the endometrium. Per- 
haps I should expand that, but I have chosen, to leave 
it as endometrium and subdivided it into ovarian and 
systemic etiology. 

What do we mean by diseases of the embryo? I 
can list some vei-y obvious factors; a common one 


6 


Journal of Iowa State Medical Society 


January. 1945 


among physicians is exposure to roentgen rays, in 
which the sperm is sufficiently damaged that preg- 
nancies resulting therefrom habitually abort, or the 
couple is unable to conceive. 

Just as the obvious damage by roentgen rays can 
be recognized, we may also damage either the ova 
or the sperm by toxic drugs, by nutritional deficien- 
cies, and by other systemic problems. 

When a patient presents herself with a history of 
two or more sequential abortions, you become obli- 
gated to study her medically rather than obstetri- 
cally. Investigate the wife and the husband for evi- 
dence of blastophthoria. These evidences are not 
often easy to obtain. 

One patient that I had the privilege to see was in 
a family who had recently dug a new well on their 
farm. The water and new lead pipe ^ was of such 
chemical composition that a mild grade of lead pois- 
oning developed and this produced sufficient damage 
to the sperm that abortion ensued. It is chiefly a 
medical investigation and the ramifications are un- 
limited. 

As far as the woman is concerned, she may share 
only half of the responsibility. She has all of the 
problems damaging the ova that apply to the male. 
She has, in addition, the problems of her own sys- 
temic development which may complicate the develop- 
ment of the pregnancy. We know the effect of 
hypertension and of chronic nephritis. We know the 
effect of other systemic diseases which affect the 
developing embryo, both occult and obvious. 

In the last few years we have also become aware 
of certain, shall we say allergic problems which come 
under the general heading of the Rh factor in which 
the union of the sperm and the ova incite abnormal 
allergic responses to the destruction of the embryo. 

I am afraid I have not clearly answered your ques- 
tion, except to point out the great ramifications in- 
volved. Such a patient is more a medical problem 
than an endocrine problem. It is useless to treat her 
with progesterone, let’s say, if she has a damaged 
fetus to begin with. You must back up and treat 
this patient before she is pregnant and not after. It 
is a medical, not an endocrine problem. 

There is one exception to that rule, and that is 
the use of our time-honored and probably only reli- 
able endocrine-thyroid. I believe that thyroid prob- 
ably does its work as a nonspecific metabolic stimu- 
lant involving all tissues, including the ovary and 
also including the testes. Dont’ forget friend “Papa”. 
He may be responsible. 

Lastly, may I warn you that you may see an in- 
creasing number of habitual abortions. In my last 
post at the University of Nebraska, we had two 
large shell-loading factories, one for the Army and 
one for the Navy. A great many evidences of poison- 
ing are developing from the chemicals used in ex- 
plosives. I saw two abortions which we thought 
were due to toluene poisoning. We may see a great- 
ly increasing number of abortions on a blastoph- 
thoric basis, from occupational hazards. 


CANCER OF THE CERVIX* 

Harold W. Morgan, M.D., Mason City 

The first carcinoma of the cervix I saw after 
entering active practice of medicine was in a girl 
twenty-six years of age. She happened to be a 
member of a religious sect which does not believe 
in sin and disease but, of course, the cancer didn’t 
know this and kept right on growing. She <lied 
about nine months after she was first seen in the 
hospital. I dO' not know what treatment was used : 
if she had any, it was given elsewhere. 

In the last two years in Iowa there have been 
seven deaths from carcinoma of the cervix in 
patients under thirty years of age, one under 
twenty-five years of age. -There has been one 
death in a patient between ninety-five and one 
hundred years of age. A summation of the age 
grouping in deaths from carcinoma of the cervix 
reveals that forty-five to seventy is the commonest 
age period for carcinoma of the cervix. In the 
first ten months of 1943 there were as many deaths 
from this type of cancer as in the twelve month 
period of 1942. 

It is well to classify the cervical cancer mostly 
for prognostic value and to aid in a statistical 
evaluation of treatment. For ordinary purposes 
clinical grouping into four classes is most satis- 
factory, as the League of Nation’s classification. 
Since extensive treatment should be administered 
irrespective of the group into which the case falls, 
the grouping of a cancer should not control the 
amount of treatment given. Group one represents 
malignancy definitely limited to the cervix ; group 
two includes those in which there is doubtful locali- 
zation or some extension into the body of the 
uterus ; group three shows definite infiltration of 
the perimetrial tissue ; and in group four these 
findings are present plus fixation of the uterus, 
possibly extensive involvement of the vagina, rec- 
tum, or bladder. It is sometimes possible to 
determine the presence of metastasis. Groups one 
and two may be considered as cases seen in rea- 
sonably early stages, and unfortunately very few 
are seen in these groups. Groups three and four 
are those most commonly found. 

treatment of carcinoma of cervix 

The treatment of this condition is fairly well 
standardized and should be in the average case a 
problem of proper irradiation. In most cases this 
is done by the combined use of radium and roent- 
gen therapy, although occasionally only one of 
these procec^ires may be used. The time is past 
when renting a bar of radium and placing it in the 
cervical canal for a length of time, advised by a 

*Presented before the Ninety-Third Annual Session. Iowa State 
Medical Society, Des Moines, April 20 and 21, 1944. 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


7 


doctor who has never seen the case or by some 
radium lal)oratory, can he considered as adequate 
treatment. The physical factors used in x-ray 
treatment with deep x-ray therapy or considered 
in the placing of the radium about the cervical 
lesion are as important as the details connected 
with a surgical procedure. Placing -radium in the 
center of a lesion with the expectation of com- 
pletely treating the extensions of the lesion is not 
sufficient. The same amount of radium properly 
distributed about the periphery of the lesion may 
mean the difference between a cure and the death 
of that patient. Radium is effective for a distance 
of approximately one inch at the most in the treat- 
ment of malignant diseases. 

If a combination treatment of x-ray and radium 
seems advisable, experience is necessary in deter- 
mining which agent should be used first. If the 
lesion is primarily one of ulceration with rela- 
tively little over-growth of tissue, it makes little 
difference whether radium or x-ray is used first. 
The local lesion may be controlled by the radium 
and then the pelvis irradiated by deep x-ray ther- 
apy. In cases in which there is a large fungating 
mass present and in which infection is present, it is 
inadvisable to use radium at the start of the treat- 
ment. A pelvic infection may be lighted up. In 
most of these instances, if treatment is with deep 
x-ray therapy carefully administered, the fungat- 
ing mass will disappear and the infection will dis- 
appear either during the course of the x-ray ther- 
apy or shortly thereafter. It is then technically 
much easier to place the radium properly than it 
is when a large mass is present. 

Many doctors now are treating carcinoma of the 
cervix entirely with roentgen rays. This is done 
by a combination use of deep x-ray therapy and 
local irradiation on the lesion of the cervix. A 
special vaginal speculum with expanding arms is 
used to expose the cervix and surrounding tissue 
and the lesion is treated in much the same fashion 
as an epithelioma of the skin elsewhere on the 
body would be treated. I have had no personal 
experience with this method but see no reason why 
it should not be entirely satisfactory. There is 
seldom any difficulty in controlling the local lesion 
with properly administered irradiation. The great- 
est difficulty is controlling the spread or the metas- 
tasis. 

Tossig in St. Louis has devised an extensive 
operation with dissection of the lymphatic glands 
on both sides of the pelvis and occasionally ex- 
tends his operation into the abdominal cavity. He 
has increased the number of cures in these cases 
by such a procedure. This operation does not dis- 
place the use of radiation but rather supplements it. 

At this time I should like to make a plea for the 


reporting of cancer cases in vital statistics. If we 
are to have reliable figures upon which to base our 
plans for cancer control work, the disease should 
be made a reportable one. As nearly as we can 
determine, the ratio of cancer cases treated in hos- 
pitals to cancer deaths is 1 :7. Cancer of the uterus, 
not exclusively cervix, for the past five years has 
accounted for a total of 1,515 deaths or 17.3 per 
cent of female deaths ; in other words, one out of 
every six deaths among women in Iowa has oc- 
curred from carcinoma of the uterus. 

Diagnosis of carcinoma of the cervix in the 
average case is easy. Unfortunately these patients 
usually appear late in the course of their disease. 
In general there is a fungating mass present in 
the cervix which has become secondarily infected 
so that the surface is necrotic and the tissue is 
extremely friable. It bleeds easily on the slightest 
manipulation. In other instances the cervix shows 
deep ulcerations and tissue is destroyed as rapidly 
as it develops leaving only the ulcer extending into 
the surrounding tissue. Occasionally a cancer of 
the cervix will develop high in the cervical canal 
and not present itself at the os until well estab- 
lished. This type of tumor, usually an adeno- 
carcinoma, fortunately is rare. 

Early cases are much more difficult to diagnose 
and the final diagnosis in most cases will depend 
upon biopsy. This should be done in all cases. 
My personal experience with the Schiller test has 
not been particularly satisfactory. I have seen at 
least one definitely proved carcinoma of the cervix 
which took the bi'own stain with Lugol’s solution. 
If you are conscientiously looking for carcinomas 
of the cervix, you will find many negative biopsies. 
In fact, when I was asking for material in prepar- 
ing this paper one of the surgeons I approached 
said, “I haven’t seen one for a long time; you re- 
port all of the specimens I send you negative for 
malignancy.” As a pathologist, let me make a 
plea for larger biopsies. Do not expect too much 
of a report on a microscopic piece of tissue. Re- 
move the biopsy from the margin of the lesion, 
since often the determination of invasion of nor- 
mal tissue is of extreme importance in the diag- 
nosis, and place it in 10 per cent formalin, not in 
alcohol. 

In differential diagnosis, as a general rule, there 
are few things which will be confused with carci- 
noma of the cervix. Syphilis and tuberculosis 
occasionally may occur but are extremely rare. 
Ordinarily polyps are not malignant, particularly 
if attached by a narrow pedicle. They are fre- 
quently necrotic and may show gangrenous changes 
but are seldom of a malignant nature. 

In conclusion, carcinoma of the cervix will be 
found if one bears in mind the possibility of the 


8 


Journal of Iowa State Medical Society 


January, 1945 


condition being present in all patients showing 
spotting, bleeding, ]iarticularly intermenstrual or 
after the menopause, an<l where adequate diagnos- 
tic measures are undertaken. 

As our friend, Dr. Baldridge, used to say, “The 
most important point in making a diagnosis is to 
consider the possibility of such a condition being 
present.” 


THE USE OE DELAYED BONE GRAFTS 
IN UNUNITED FRACTURES OF 
THE JAW* 

Edmund S. Donohue, M.D., Sioux City 

The mandible is an isolated bone which forms 
the framework of the lower part of the face. It 
is suspended from the temporomandibular joint 
and is held in place, yet made freely movable, by 
the surrounding muscles and ligaments. The man- 
dible is a strong bone, its structure consisting 
chiefly of cortical bone. Two factors, however, 
contribute to its frequent fracture: First, the fact 
that it is so prominent that it is exposed to trauma, 
and second, it is horseshoe-shaped so that a blow 
on the lateral side often produces a fracture. 

With an ununited fracture of the jaw there is- 
a definite disturbance in the continuity of the face. 
There is also an interruption in effective mastica- 
tion of food, which depends entirely upon har- 
monious occlusion of the teeth. 

The principal etiologic factors of nonunion are: 
The destruction of nutritional vessels ; compound 
fracture with subsequent infection ; loss of bone ; 
lack of contact; presence of tooth roots in the 
fracture line; inadequate fixation, and metabolic 
disturbance. 

I wish to present two case histories and the 
technic we are employing on all delayed bone 
grafts of the jaw. We owe all of our present 
knowledge on this subject to the effects of Inclan^ 
of Havana, Cuba, who in 1941 presented before 
the academy his preliminary report on the use of 
preserved bone grafts. This report concerned 
homologous and autogenous grafts which were 
kept in citrated blood, saline, or plasma at a tem- 
perature of 37 to 40 degrees Fahrenheit for a 
maximum time of sixty-three days and wei*e used 
successfully. 

The question may arise as to the disadvantage 
of subjecting a patient to two operations. The 
added expense of two operating room fees, and a 
longer stay in the hospital ; but the advantages far 
outnumber the disadvantages in the elimination of 
shock and cutting down the risk of infecting the 

♦Presented before the Ninety-Second Annual Session, Iowa State 
Medical Society, Des Moines, April 29 and 30, 1943. 


graft bed. If the two operations were attempted 
at once, much more time woultl lie required. Usu- 
ally a patient with an ununited fracture of the jaw 
has spent many months with his jaws wired or 
wears some sort of splint. As a result the patient 
does not receive the proper nourishment, has lost 
weight, and is in a debilitated condition. Such 
patients are hazardous risks in long operations. 

TECHNIC OF REMOVING GRAFT 

Any anesthesia the patient desires may be used 
for this operation : local, intravenous, or general. 
The usual incision is made over the anteromedial 
aspect of the tibia with dissection carried down 
to the bone. A massive bone graft of the desired 
length and width is then removed, with either a 
single or double blade saw. Upon its removal it 
is placed in warm, normal saline solution until 
hemostasis has been obtained and the wound su- 
tured and dressed. The graft is then transferred 
to a small glass container with a screw-on lid suffi- 
ciently large to hold the graft submerged in plasma. 
The plasma should be removed from the blood 
bank about two hours before the operation to al- 
low it to reach room temperature, thus preventing 
any unnecessary chilling of the bone cells. As 
an extra precaution, the operator may add some 
sulfathiazole powder to the plasma to insure asep- 
sis. The bottle and its contents should then be 
wrapped in sterile draperies and placed in the re- 
frigerator until used, with the temperature being 
maintained at 37 to 40 degrees Fahrenheit. On 
the day of operation it is removed from the re- 
frigerator about two hours before it is to be used 
and allowed to gradually reach room temperature. 
If there has been considerable absorption of bone 
at the fracture line resulting from an osteomyelitis 
of long standing nonunion, the normal length of 
the ramus is usually shortened. To restore normal 
length and to produce exact occlusion of the teeth, 
it may be necessary to wire the teeth before the 
second operation is done. The wires may be re- 
moved immediately after the graft is placed, how- 
ever, because the graft is strong enough to main- 
tain proper length and position providing the pa- 
tient exerts the minimum amount of common sense 
in the activity of the jaw, especially in chewing 
food. 

Intravenous anesthesia is the anesthetic of choice 
at the time the graft is to be applied. Pentothal 
sodium is particularly desirable because of its 
lower toxicity. It may be given in any accepted 
dilution and there is no contraindication in using 
it for this operation unless it would be a systemic 
contraindication. The advantages are numerous : 
It is easy to give, action is rapid, and there is a 
complete absence of anesthatist and mask from the 


VoL. XXXV, No. 1 


9 


Journal of Iowa State Medical Society 


operating field, thus giving more freedom and a 
larger operating space for the surgeon. 

At the time of the operation the graft is re- 
moved from the plasma and washed ofif in warm, 
normal saline solution. Draping of the patient is 
carried out in the usual manner. The incision is 
made externally parallel to the ramus of the jaw, 
through the skin and subcutaneous tissues, down 
and through the masseter muscle. The periosteum 
is then elevated and all cicatricial tissues and se- 
questra must be removed. The dissection is car- 
ried on down until healthy and vascular bony tis- 
sue is encountered. All bleeding and oozing is 
checked because a hematoma interposed interferes 
with healing and makes an ideal media for infec- 
tion. The exact length and width of the graft is 
then determined and fitted, so that the graft and 
the bed are in direct continuity. Considerable time 
and trouble may be saved by having a sterile vise 
on the table to hold the graft while it is shortened, 
the end beveled, or the holes drilled for the screws. 
The size of the drill used on the graft is usually a 
No. 26 drill; this allows the screws to slip in and 
out of the drill holes without difficulty. A No. 33 
drill is used on the recipient area ; the purpose of 
this is that when these screws become engaged in 
the bed they have a tendency to pull the graft in 
tight contact with the bed rather than push it 
away, which it would do if the drill holes were 
small enough for the screws to become engaged in 
the graft. Incidentally, the drill holes in the graft 
are counter sunk so that the screw heads are on a 
plumb with the surface of the graft and do not 
project beyond the graft, since they rarely have 
to be removed. Usually four screws are all that 
are needed, two on each end of the graft. The 
wound is then filled with a gram or two of sulfa- 
thiazole and closed in layers. 

I should like at this point to mention the impor- 
tant role sulfathiazole has played in making this 
operation more successful. This field is always 
potentially infected, even if there has been no 
clinical or x-ray evidence of activity for several 
months ; but the application of sulfathiazole pow- 
der greatly enhances the destruction of any or- 
ganisms lying dormant in the field. 

The difficulty has not been in transferring of 
bone from one part of the body to another but 
rather in holding the transferred bone in tight 
contact with the recipient area so that growth will 
take place. . . 

Various types of fixation have been developed 
and discarded during the evolution of bone graft- 
ing, such as the use of encircling bands of kan- 
garoo tendons, catgut, or wire, none of which held 
well. Beef bone screws were also tried, but these 
often acted as foreign bodies, were slow to ab- 


sorb, and had to be removed. Miller^ in 1939 
made one of the most progressive steps in improv- 
ing fixation with metal sutures, using threaded 
bicycle spokes to hold massive bone grafts, the 
end of which protruded through the skin. When 
healing was complete, they could be removed easily 
with a chuck. This indeed was a great help but 
it still had its drawbacks, the same as were en- 
countered in using the original steel screws and 
plates, namely, that of tissue reaction and absorp- 
tion. 

Our troubles were further alleviated with the 
introduction of vitallium, which has a minimum 
tissue reaction. It seldom produced necrosis or 
absorption and rarely had to be removed. When 
the alloy vitallium was first placed on the market 
it had the conventional single slot head. In 1941 
O’Donoghue® described the application of Phillip’s 
head screw to vitallium, which consisted of two 
slots rather than a single slot and these being at 
right angles. Several years prior to this Phillip’s 
head screw had been introduced into the automo- 
bile industry, to be used on highly polished parts 
of automobiles. With this type of a screw head, 
screw drivers were less apt to slip and scratch the 
metal. The same principle applies to bone work; 
with the Phillip’s head screw the driver is much 
less likely to slip when it becomes wet with blood 
and jab into the patient’s unprotected soft parts. 
Actually the aseptic technic is much improved be- 
cause the surgeon is not apt to use his finger and 
hand in maintaining the driver on the screw. 

I should like to present two cases of nonunion 
of the jaw in which delayed bone grafts were used, 
one bilateral and the other unilateral. 

case report I 

The patient, a young boy, had received a frac- 
tured jaw in a fight two months prior to the time 
he was first seen by us. During this time he had 
been under the care of another physician. Upon 
examination it was noted that there was a false 
point of motion in the right jaw at the level of the 
first molar tooth. A roentgenogram revealed a 
fracture across the first molar tooth area with a 
complete nonunion ; the first molar tooth was in 
the fracture line. A diagnosis was made of frac- 
ture of the jaw with nonunion. The first molar 
tooth was removed and x-ray examination showed 
no osteomyelitis. The patient entered the hospital 
the following day for plastic repair. 

In removing the graft an ether anesthetic was 
used. An incision was made over the right shin 
and with the use of a motor saw a graft about two 
inches long and three-fourths of an inch wide was 
removed and placed in plasma. The wound was 
closed in layers and a pressure dressing applied. 


10 


Journal of Iowa State Medical Society 


January, 1945 


A week later the graft was applied, for which 
pentothal sodium was used as the anesthetic. I'he 
right jaw was opened from the level of the cuspid 
tooth to the angle, with dissection down to the 
fracture. A definite nonunion was found. It was 
cleaned with some difficulty and the fracture lev- 
ered back into place. The previously removed 
graft was then fitted to this area. Four drill holes 
were counter sunk in the graft before it was placed 
and held secure with four one-half inch screws. 
Bone chips were then packed around the bone plate 
and the wound was closed with sulfathiazole. The 
teeth were not wired, but in most cases they prob- 
ably should have wires applied as a matter of pre- 
caution. A roentgenogram taken the following 
day showed perfect position of the graft and frac- 
ture. Six days later a caliper brace was applied 
to the patient’s leg and he was released from the 
hospital. Two and one-half months after his dis- 
charge an x-ray and clinical examination showed 
practically complete healing, and he was told he 
would be able to use his mouth for everything 
except cracking nuts. 

CASE REPORT II 

The patient was first seen with a complaint of 
compound fracture of the jaw. He had been in 
an automobile accident in which he had sustained 
multiple injuries. A crushed chest had resulted 
in traumatic pneumonia and he had been desper- 
ately ill for some time. 

General examination of the patient, a well nour- 
ished man, was negative. Examination of the face 
showed a draining sinus below the angle of the 
jaw on the left side. There was no induration in 
this area, no swelling, and not much tenderness. 
The entire right side of the body of the jaw was 
markedly swollen, tender, and hard. There was 
a foul discharge coming out of the right side of 
the jaw into the mouth and some white bone could 
be seen in this region. The teeth were wired. 
X-ray examination revealed a transverse fracture 
of the left mandible at about the level of the first 
molar tooth with marked separation of fragments 
and no evidence of callus formation. On the right 
side there was a comminuted fracture in the same 
region with many loose fragments, some of which 
were apparently dead. There was one tooth in the 
fracture line. There was no evidence of healing. 
A diagnosis was made of double compound frac- 
ture of the mandible with traumatic osteomyelitis. 

The patient was sent to the hospital where the 
wires were removed, his mouth was opened some- 
what, and one loose tooth was removed, together 
with a small piece of dead bone. The administra- 
tion of sulfathiazole was begun. Ten days later 
the patient returned to the hospital. He reported 


bal ing removed one sequestrum and there was an- 
other presenting, which was also removed. 

Plastic repair was not begun until three months 
later. Then, with the aid of an anesthetic of pento- 
thal sodium, routine removal of the grafts from 
the right shin was performed. The wound was 
closed with sulfathiazole and a pressure bandage 
applied. Five days later the grafts were applied, 
again with' the use of a pentothal sodium anes- 
thetic. An incision was made over the body and 
angle of the left jaw, with dissection down through 
the dense scar tissue and masseter muscle to ex- 
pose the fracture. No evidence of healing was 
found. The proximal fragment overlapped the 
distal fragment and there was a vertical downward 
displacement of the proximal fragment of approxi- 
mately three-fourths of an inch. The fracture was 
pried back into its normal position except that no 
attempt was made to restore the vertical position 
of the fracture. The bone fragments were then 
freshened with a chisel, the bone graft used as a 
bone plate with No. 27 drill holes in the graft and 
No. 33 drill holes in the mandible, two posterior 
and two anterior to the fracture line, and then 
five-eighths inch ordinary machine vitallium screws 
were used to hold the graft in place. Firm fixa- 
tion was obtained. The wound was closed with 
sulfathiazole. The same procedure was carried 
out on the right side except that on that side there 
was no displacement found and a small free graft 
was placed between the fracture bone ends. The 
wound was closed with sulfathiazole. The pa- 
tient’s postoperative condition was good. A roent- 
genogram taken the following day showed the 
grafts in good position. The teeth were then wired 
and ten days later the patient was fitted with a 
brace on his right leg and was released from the 
hospital. 

X-ray examination of the patient’s jaw three 
months after his release from the hospital showed 
complete healing on both sides and the wires could 
then be removed. A roentgenogram of his right 
leg revealed that the tibia was filling in satisfac- 
torily and the patient was informed he could re- 
move the brace while he was in the house. 

BIBLIOGRAPHY 

1. Inclan, A, : Use of preserved bone graft in orthopaedic sur- 
gery. J. Bone & Joint Surg., xxiv;81-96 (January) 1942. 

2. Miller, O.: Personal communication, 1939. 

3. O’Donoghue. A. F. : Phillip’s recessed head screw. Am. J. 
Surg., liv:758 (December) 1941. 


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VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


11 


MASTOIDITIS COMPLICATED BY 
SULFONAMIDE INTOLERANCE* 
Report of a Case 

Carl E. Sampson, M.D., Creston 

The following case is presented to illustrate 
one of the hazards encountered in sulfonainido- 
therapy. 

case report 

Present Comf'laint : The patient, a girl twelve 
years of age, was brought to the hospital on the 
evening of Eebruary 11, 1944, by the family phy- 
sician of her stepfather. The child had contracted 
a slight cold about two weeks before, had devel- 
o]ied an earache, and the following morning her 
right ear had begun to discharge. After six days 
the family physician was called from' a town 
twenty miles distant to examine the girl. He 
made a diagnosis of acute mastoiditis and brought 
the child in for examination. 

Past History: The patient gave a history of 
having had chickenpox, two types of measles, and, 
at the age of eight years, scarlet fever. She had 
been very ill with scarlet fever but had developed 
no complications. There was no history of a dis- 
charging ear previous to the present infection. 
The preceding September the child had had swol- 
len glands in the neck with a slight fever and had 
been listless for a period of two weeks. At that 
time she was out of school several days, and since 
then has been absent several times from one to 
three days because she did not feel well. Her 
mother stated she had ner’er been able to stand 
• what other children could. There was no history 
of sulfa drugs having been given previously. 

Family History: The child’s father died from 
tuberculosis when she was one year of age. The 
father had been ill with the disease six months 
before his death ; however, the patient had never 
had a tuberculin test. One brother, sixteen years 
of age. is apparently in good health. He plays 
basketball on the high school team. The mother 
teaches school and the children live with the grand- 
mother. 

Physical Examination : On examination one 

found a well developed, anemic appearing child, 
rather large for her age. There was a profuse, 
purulent discharge coming from the right ear. 
There was slight edema of the superior canal wall 
and tenderness was elicited on pressure over the 
process. There was slight edema over the mas- 
toid. which was evident after maintained pressure. 
The nose showed a little discharge but the throat 
was negative. The chest was clear to percussion 
and ausculation. No tenderness or masses were 

*Presented before the Ninety-Third Annual Session, Iowa State 
Medical Society, Des Moines, April 20 and 21, 1944. 


found in the abdomen. Her temperature was 
100.8 degrees, pulse 92, and respirations 24. A 
complete blood count revealed 5,470,000 red blood 
cells: 14,250 white blood cells: hemoglobin 85 per 
cent: 65 segment nuclears : 12 stab nuclears: 6 
large lymphocytes: 12 small lymphocytes: 1 eosin- 
ophil; 1 basophil: and 3 monocytes. (The pa- 
tient’s red cell count and hemoglobin were in bet- 
ter condition than one would expect from her ap- 
pearance.) The urine was negative for albumin 
and sugar and the microscopic examination was 
negative. 

Course in Hospital: With the above count, one 
felt safe in prescribing sulfonamide drugs : and 
sulfadiazine administration was started that night 
in adequate doses. The next morning roentgeno- 
grams of the mastoids were taken which revealed 
extensive and well pneumatized processes. The 
right process showed some cloudiness and large 
cells at the tip and along the posterior border. 
There was no breaking down of the intercellular 
walls. The child had a comfortable night. The 
morning temperature was 98 degrees, pulse 100, 
and respirations 20. During the next three days 
the temperature varied between 97.6 and 98.6 de- 
grees, the pulse rate from 70 to 100, and respira- 
tions from 18 to 28. She was more comfortable, 
the discharge was less profuse, and there was less 
tenderness over the process. In spite of apparent 
clinical improvement, the child appeared more 
anemic. The following blood count verified this: 
Red blood cells, 3,610,000: white blood cells, 
6,050 : hemoglobin 66 per cent ; 56 segment nu- 
clears; 13 stab nuclears: 14 large lymphocytes; 9 
small lymphocytes ; 3 eosinophils ; 3 basophils ; and 
2 monocytes. This picture showed anemia but 
no granulocytopenia. Sulfa concentration in the 
blood showed 6 milligrams per 100 cubic centi- 
meters. Sulfadiazine was discontinued and the 
child was given reticulogen intramuscularly. The 
blood count was checked daily. 

On February 21, she had a red cell count of 
5,240,000; white count of 9,800; hemoglobin 74 
per cent ; 68 segment nuclears ; 9 stab nuclears ; 7 
large lymphocytes ; 7 small lymphocytes ; 1 eosino- 
phil ; 1 basophil ; and 7 monocytes. This presented 
a better blood picture, but in the interval clinical 
signs and symptoms of mastoditis increased. Surgi- 
cal intervention, which had been advised earlier, 
was performed on the following day. Granulations 
were encountered and pus was released under 
pressure from the region of the antrum and from 
the large cells along the posterior border. The 
process was rather deep anteriorly, but a broad 
sinus fairly well forward caused the development 
of a shallow extensive cellular structure poster- 
iorly. No sulfanilamide was placed in the wound 


12 


Journal of Iowa State Medical Society 


Januar3L 1945 


as has been the custom of the writer for the past 
few years. 

A smear, taken at the time of the operation, 
showed Diplococcus. No culture was made. The 
postoperative temperature of the patient rose to 
102.6 degrees the following day and the pulse to 
130, subsiding to normal by the fourth postoper- 
ative day. She was dressed and up in a chair on 
the eighth day and walking about her room until 
discharge from the hospital on the fourteentli day. 
At this time the blood count showed : Red blood 
cells, 4,810,000; white blood cells, 9,700; hemo- 
globin, 70 per cent ; segment nuclears, 65 ; stab 
nuclears, 8 ; large lymphocytes, 12 ; small lympho- 
cytes, 10; eosinophils, 2; and monocytes, 3. A 
tuberculin test was reported as negative and subse- 
quent counts have shown no anemia. ' Her family 
physician reports that she has had a rather slow 
convalescence, but has gained eight pounds in 
weight. 

COMMENT 

We have all been using the sulfonamides to 
good advantage in infections of the ear, nose, and 
throat, but occasionally we have a patient who is 
intolerant or sensitive. This case illustrates the 
necessity for frequent checks on the blood while 
administering such drugs. 


MIDWEST CONFERENCE ON REHABILITATION 

The Institute of Medicine of Chicag-o is sponsoring 
a Midwest Conference on Rehabilitation to be held in 
the Grand Ball Room of the Drake Hotel, Chicago, 
Monday, February 12. This conference precedes by 
one day the Congress on Industrial Health, under 
the auspices of the American Medical Association, 
and will be held in conjunction with that meeting. 
Cosponsors are the Chicago Medical Society, the 
Council of Social Agencies of Chicago, the Chicago 
Hospital Council, and the Midwestern Section of 
the American Congress of Physical Medicine. Na- 
tionally known authorities will participate in the 
one-day program which will include discussion of the 
relation of the local community to the Veterans’, 
Federal, and State rehabilitation programs, role of 
industry in rehabilitation, employability of the handi- 
capped, and development of local rehabilitation cen- 
ters. There will also be a luncheon program with 
jpecially invited guests, and the Sixth Frank Billings 
Lecture of the Thomas Lewis Gilmer Foundation of 
the Institute of Medicine will be delivered at the 
evening session. Further details will be announced 
later. The registration fee will be $1.00. Requests 
for programs and registration cards should be sent 
to the Institute of Medicine of Chicago, 86 East 
Randolph Street, Chicago 1, Illinois. 


NATIONAL CONFERENCE ON MEDICAL 
SERVICE IN CHICAGO FEBRUARY 11 

Postwar distribution of medical care will be the 
theme for the nineteenth annual session of the Na- 
tional Conference on Medical Service to be held in 
the Red Lacquer Room of the Palmer House in 
Chicago, Sunday, February 11, 1945. 

Medical legislation, physical fitness program, re- 
habilitation of veterans, latest word from the Wash- 
ington front, relationship between labor and farm 
groups and medicine are among the topics to be dis- 
cussed by nationally known speakers who will appear 
on the program. Also listed on the program will 
be an open discussion on prepayment medical plans, 
the principal advantages and defects of both service 
and indemnity types of insurance being presented. 
Congressman Arthur L. Miller of Nebraska, author 
of the Miller Bill to unify certain health services, is 
to be among the speakers. 

All members of the American Medical Association 
are invited to attend. 

C. L. Palmer, M.D., Pittsburgh, president of the 
conference, will open the session with an address 
from the chair at 9:30 a. m. Members of the con- 
ference executive committee, in addition to the 
president and secretary, are W. L. Burnap, M.D., 
Fergus Falls, Minnesota; J. D. McCarthy, M.D., 
Omaha, Nebraska; Edwin S. Hamilton, M.D., Kan- 
kakee, Illinois; Walter E. Vest. M.D., Huntington, 
West Virginia; Russell M. Kurten, M.D., Racine, 
Wisconsin; Creighton Barker, M.D., New Haven, 
Connecticut; and Dwight H. Murray, M.D., Napa, 
California. 

Detailed programs of the conference may be ob- 
tained through any member of the executive com- 
mittee or by writing Cleon A. Nafe, M.D., secretary. 
National Conference on Medical Service, 822 Hume 
Mansur Building, Indianapolis 4, Indiana. 


SPEAKERS BUREAU RADIO SCHEDULE 
WOI — Tuesdays at 1:00 p. m. 

WSUI — Thursdays at 9:00 a. m. 

January 2- 4 The Treatment of Pneumonia 

Ernest J. Voigt, M.D. 

January 9-11 High Blood Pressure 

Byron L. Basinger, M.D. 

January 16-18 The Role of Endocrinology in Good 
Health 

Paul D. Anneberg, M.D, 

January 23-25 Influenza 

John E. Christiansen, M.D. 

January 30- Insomnia 

February 1 Norman D. Render, M.D. 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


13 



Pneumoinia Deaths and Case Notification 


pneumonia mortality in IOWA 

In the following table, figures show the annual 
number of deaths from lobar pneumonia, broncho- 
pneumonia, and all forms of this disease, for the 
decade 1934 through 1943, and the first nine 
months of 1944. 

table I 

Pneumonia Deaths in Iowa 1934-1944 (1st 9 Mos.) 


Year Lobar Broncho Unspecified All Forms 

1934 1.020 924 21 1,966 

1935 1,078 835 16 1,929 

1936 1,170 909 21 2,100 

1937 962 769 14 1,745 

1938 882 739 26 1,647 

1939 700 649 31 1,380 

1940 656 616 42 1,314 

1941 493 541 48 1,082 

1942 453 467 42 962 

1943 454 522 43 1,019 

1944 (1st 9 Mos. I 367 381 25 773 


The figures in this table indicate a remarkable 
decrease, beginning in 1937, in total deaths from 
lobar pneumonia and bronchopneumonia (includ- 



PNEUMONIA mortality in IOWA— 1934-1943 
Showing Trend of Deaths Due to Lobar Pneumonia and to 
Bronchopneumonia (Lobular and Interstitial Forms) 


ing lobular and interstitial forms). The advent of 
sulfonamide drugs, the use of type-specific anti- 
pneumococcic serum, emphasis on accurate bac- 
teriologic diagnosis, and early treatment are chief 
factors to account for the great lowering of the 
death rate from 78.7 per 100,000 during the three- 
year period 1934-1936 to 40.2 per 100,000 for the 
years 1941-1943. 

Since 1941, deaths from lobar pneumonia have 
been exceeded by those recorded as due to broncho- 
pneumonia. This is clearly brought out in the 
accompanying line diagram, derived from the fig- 
ures in the first two columns of Table I. 

REPORTING OF ACUTE LOBAR PNEUMONIA 

On November 3, 1944, the Commissioner for- 
warded to staff physicians, superintendents of hos- 
pitals, and medical directors of district health serv- 
ices in Iowa, the following letter requesting com- 
plete reporting of cases of acute lobar pneumonia ; 

Dear Co- Workers: 

On behalf of the Iowa State Department of Health, 
it is desired to enlist your continued support of 
efforts to secure adequate reporting of acute lobar 
pneumonia. 

This office requests that pneumonia report cards 
... be used to notify the Department of all cases of 
acute lobar pneumonia that receive treatment in the 
hospital. It is suggested that the report cards be 
mailed from the Superintendent’s office and com- 
pleted by the record librarian, or by the laboratory 
worker if bacteriologic diagnosis is made. 

Clerical work will be minimized by filling out the 
pneumonia report card at the time the hospital record 
is considered at staff meeting or when diagnosis has 
been clearly established. The report cards carry the 
franking privilege and do not require postage. Addi- 
tional cards will be forwarded promptly on request. 
Envelopes may be used if preferred. 

The method of reporting as above outlined is de- 
signed to conserve the doctors’ time and effort. The 
report card will not be followed by a letter requesting 
more detailed information, except for cases that have 


14 


Journal of Iowa State Medical Society 


January, 1945 


the benefit of laboratory work with fincling' of 
Pneumococcus of important types such as I to VIII 
and XIV. 

Physicians treating acute lobar pneumonia in the 
home are requested to report cases to the District 
Health Office on cards addressed to that office or to 
the State Department of Health. 

The Department will provide the following on 
request: 

1. Blood culture outfits without cost. 

2. Pneumococcus and Friedlander typing serum 
without cost. 

3. Reimbursement to the hospital for the cost of 
penicillin when the attending physician indi- 
cates patient’s inability to pay. 

4. Type-specific curative anti-pneumococcic serum 
when the attending physician indicates patient’s 
inability to pay. (Serum for con]mon types I 
to VIII and XIV may be obtained through the 
State Department of Health.) 

Thanking you and staff physicians for interest in 
the reporting of acute lobar pneumonia and trusting 
that the State Department of Health may continue 
to be of seiwice, I am, 

Very sincerely yours, 

Walter L. Bierring, M.D., 
Collaborating Epidemiologist and 
Health Commissioner. 


DIPHTHERIA MORBIDITY AND MORTALITY 
IN IOWA 

Data with reference to reported cases of diph- 
theria, deaths from this disease and the annual 
death rate per 100,0(X) population in Iowa for the 
fifteen-year period 1930-1944 (through December 
20 for cases, and provisional deaths as recorded 
through November), are presented in Table 
II as follows; 

table II 

Diphtheria Cases and Deaths in Iowa 

Deaths 


Year 

Cases 

No. 

Rate Per lOOM 

1930 

. 412 

44 

1.8 

1931 

. 509 

62 

2.5 

1932 

. 657 

50 

2.0 

1933 

. 563 

55 

2.2 

1934 

. 415 

38 

1.5 

1935 

. 599 

66 

2.2 

1936 

. 289 

26 

1.0 

1937 

. 179 

11 

0.4 

1938 

. 395 

24 

1.0 

1939 

. 305 

15 

0.6 

1940 

. 190 

15 

0.6 

1941 

. 199 

8 

0.3 

i942 

. 187 

10 

0.4 

1943 

. 156 

12 

0.5 

1944 (through Dec. 20) 

. . 196 

7 (1st 11 mos.) — 


5,251 

433 



REPORTED MORBIDITY BY MONTHS, 1944 

The accompanying table (Table III) shows the 
number of cases of diphtheria which were expected 


to be reported for the months of 1944, based on 
the month-by-month average for the nine-year 
period 1935-1943 (column one in table) : also the 
number of cases as actually oh.scrz'cd and reported 
during the months of the past year. 

TABLE III 

Reported Incidence of Diphtheria by Months, 1941 


Month Expected Cases Observed Cases 

9-Year Average as Reported 
1935-1943 1944 

January 28 22 

February 23 19 

March 17 23 

April 19 13 

May 15 11 

June 10 9 

July 8 11 

August 15 8 

September 23 11 

October 23 9 

November 21 39 

December 18 21 (through Dec. 20) 


It will be noted in Table III that diphtheria 
developed unusual prevalence in the state, begin- 
ning in November 1944. 

DIPHTHERIA DEATHS IN 1944 

Provisional deaths from diphtheria as recorded 
for the first eleven months of 1944 numbered 7. 
Four deaths occurred in November, two each in 
Page and Woodbury Counties. None of those 
who died had been actively immunized against 
diphtheria ; there w^as delay on the part of parents 
in calling the attending physician and in adminis- 
tration of antitoxin. 


PREVALENCE OF DISEASE 

Most Cases 


Disease 

Nov. *44 

Oct. *44 

Nov. *43 Reported From 

Diphtheria 

...39 

9 

14 

Page. Woodbury 

Scarlet Fever . . . . 

. .224 

137 

252 

Polk, Linn 

Typhoid Fever . . . 

. . 4 

1 

8 

Linn, Lucas, Polk, 
Wright 

Smallpox 

.. . 1 

0 

1 

story 

Measles 

...40 

10 

140 

Guthrie, Ida 

Whooping Cough. 

..17 

42 

148 

Boone, Des Moines 

Brucellosis 

. . 35 

19 

21 

Allamakee, Clayton, 
Pocahontas 

Chickenpox 

. .240 

51 

347 

Black Hawk, Wood- 
bury, Calhoun 

Germnn Measles . 

. . 2 

2 

36 

Greene, Washington 

Influenza 

. . 1 

0 

5 

Boone 

Malaria 

Meningococcus 

.. 75 

31 

1 

Page, Clinton 

Meningitis . . . . 

. . 3 

8 

2 

Black Hawk, Clayton, 
Monroe 

Mumps 

. .121 

78 

48 

Johnson, Dubuque, 
Sac 

Pneumonia 

. . 32 

5 

16 

Clinton, Black Hawk 

Poliomyelitis . . . . 

.. 14 

60 

8 

Winneshiek 

Tuberculosis . . . . 

.. 39 

66 

33 

For the State 

Gonorrhea 

. .244 

231 

130 

For the State 

Syphilis 

. .163 

121 

156 

For the State 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


15 



ISSUED MONTHLY 


Lee Forrest Hill, Editor 

Dennis H. Kelly, Associate Editor 


PUBLICATION COMMITTEE 

Lee Forrest Hill, Editor 

Dennis H. Kelly, Associate Editor 

Robert L, Parker, Secretary 

Oliver J. Fay, Trustee 

John I. Marker, Trustee 

Walter A. Sternberg, Trustee 

.Mount Pleasant 

SUBSCRIPTION $3.00 PER YEAR 

Address all communications to the Editor of the Journal, 

§os Bankers Trust Building, Des Moines p 

Office of Pcblication, Des Moines 

9, Iowa 

Vol. XXXV .JANUARY, 194.5 

No. 1 


THE OLD YEAR ENDS— A NEW ONE BEGINS 

Following its usual custom the Journal again 
this year wishes to extend to all of its readers the 
greetings of the season. A year ago, in this col- 
umn, we expressed the hope that by the year's end 
we all might be united again in our peaceful pur- 
suits at home and be with our families at our fire- 
sides. But the unseen Gods who rule our destinies 
have decreed otherwise. Our friends and our 
colleagues in military service are still scattered to 
the four corners of the earth, and to them we send 
a special message of greeting and repeat the fer- 
vent hope that this New Year may bring what we 
all so earnestly pray for — peace and the return of 
our comrades. 

As we look back over the events of the past year, 
our thoughts turn first to those of our number who 
wear the uniform of their country. It is with 
pride that we report to them that the nation’s 
praise has been repeatedly heaped upon them for 
the superlative job they have done and are doing 
in attending the medical needs of our fighting men, 
both on foreign battlefields and in the home train- 
ing camps. Never before has scientific medicine 
risen to such heights of accomplishment as in this 
war. In many a home this holiday season hearts 
will be gladdened by the knowledge that a “cas- 
ualty” will be coming home one of these days to 
join his loved ones who might otherwise remain 
forever on foreign soil because blood and plasma 
and sulfonamides and penicillin, along with med- 
ical skill, were on the spot to save his life. To these 
“medicos” and to the members of their adminis- 
trative corps who by day and night brave the 
frightful din of exploding bombs and the hail of 
bullets in the very front lines, and sometimes even 


in enemy territory, in searching out and bringing 
liack on stretchers our wounded hoys — to these 
unsung, undecorated, everyday heroes whether on 
land or sea — those of us here at home would send 
you at this season a message of understanding of 
the sacrifices you are making and the Hell you are 
experiencing that your country and your homes 
may remain unscathed and free from the tyrant’s 
heel. That your sacrifices and those of the thou- 
sands of comrades with you this time may not have 
been in vain is the New Year’s wish we would ex- 
tend to you. May God give the leaders of our 
nation the wisdom and the courage through the 
coming years to so guide the destinies of our land 
that never again will the necessity arise for the 
waging of another war. 

We would also like you to know — those of you 
who are away from home in military service — that 
your colleagues in the medical profession whose 
duties are on the civilian front are meeting their 
obligations no less heroically but in a different way. 
Some of our number have succumbed during the 
past year. They are casualties of the war effort as 
truly as those on the battlefi'ont. To their families 
and friends we would voice our sympathies for the 
bereavement we know must be especially poignant 
during this festive season. Others are carrying 
on magnificently the double and triple load of 
meeting the needs of the folks at home made neces- 
sary by your absence. Just as you on the military 
fronts are doing an unexcelled job, so are the 
civilian doctors on the home front. So far as we 
know none of our people, at least in our state, 
are suffering from lack of medical care. To be 
sure, our hospitals are crowded to capacity and 
beyond and doctors are working long hours and 
far into the night to meet all the demands made 
upon them. But the job is being done and we be- 
lieve well done. We speak of this especially 
because we should like you and the servicemen 
about you to know that you need have no worries 
concerning the medical care of those close to you 
whom you have left at home. 

We know, too, that many of you are worried lest 
in your absence the free private practice of 
medicine to which you look forward to returning 
with such enthusiasm and expectation, may in the 
meantime have become changed by the infiltration 
or frank domination of government. It cannot be 
denied that medical practice is currently the sub- 
ject of considerable controversy. What modifica- 
tions will emerge in the postwar period no one at 
this time can prophesy with accuracy. There are 
those — mostly advocates of some such proposal as 
the Wagner-Murray-Dingell Bill — who feel that 
sweeping changes are necessary. Advocates of 
such proposals are to he found chiefly among the 


16 


Journal ok Iowa State Medical Society 


January, 1945 


labor and farm grou]>s and the social service work- 
ers and reformers who reside in large cities, es- 
pecially in Washington. The former of these have 
powerful blocs in the Capitol, and all of them are 
undoubtedly using every opportunity to advance 
their cause with our Congressmen. It seems 
doubtful, however, that there is any immediate 
danger of a sudden legislative edict which would 
force a system of state medicine ujion the nation. 
Many other proposals are being advanced to meet 
what are considered to be the needs of our chang- 
ing social and economic structure. Among these 
are the plan of the American Public Health Asso- 
ciation, the Kaiser plan for industrial organiza- 
tions, and the LaGuardia plan for the employees 
of New York City. 

The physicians themselves have recognized that 
certain extensions of medical service programs to 
meet the security needs of employed persons in low 
income groups are desirable ; and some twenty 
states, including Iowa, are busy in perfecting plans 
for the launching of such programs based on vol- 
untary insurance principles. To the extent to 
which these are successful, and in combination 
with an almost certain government sponsored post- 
war expansion in hospital construction, would 
seem to depend the answer as to whether pres- 
sure will be continued for an all-out form of 
state medicine. Increasing socialization of medicine 
is inevitable, but state medicine is a culmination 
which all of us must oppose to the limit of our 
abilities. It would seem entirely possible that meth- 
ods of extending medical service to meet the needs 
of all our people and yet within the framework of 
private practice, with government cooperation 
where needed instead of government domination, is 
a postwar attainable goal. In the meantime, those 
of us here at home will do our best to hold the fort 
for_you, so that together when the war is over we 
may face the future united and with vigor. 

And so in this holiday season we would again 
extend a New Year’s greeting to all our profes- 
sion — those in uniform and those at home — and 
say to you that we are proud of the job you are 
doing, and that we are looking forward eagerly to 
the day when we can all be together again to face 
side by side the new tasks of the postwar period. 


1945 DUES 

Dues should be received for 1945 before Feb- 
ruary 1. Maintain your state membership and 
send a check to your county secretary at once! 


DEDICATION OF RAYMOND BLANK 
MEMORIAL HOSPITAL FOR 
CHILDREN 

During the afternoon of December third. Dr. 
Oliver J. Fay presided over dedicatory exercises 
for the completed Raymond Blank Memorial Hos- 
pital for Children. Some two hundred invited 
guests braved the atrocious weather to view the 
hospital and to attend the impressive ceremony. 
Later in the day an additional thousand persons 
were shown through the hospital by nurses from 
the Methodist Hospital staff. 

At the dedication. Dr. Walter L. Bierring, life- 
long friend of the Blanks, reviewed the career of 
Raymond Blank, son of Mr. and Mrs. A. H. 
Blank who died at the age of thirty-two and 
in whose memory the hospital was erected. A 
full length portrait of Raymond hangs on the 
east wall of the main lobby. Dr. Bierring spoke 
of the active interest he had taken in children’s 
organizations and of the fittingness of the Me- 
morial as a means of carrying on the work he 
himself undoubtedly would have done had he 
lived. Mr. Blank, in his address in presenting 
the keys of the new hospital to Mr. Rolfe Wag- 
ner, President of the Board of Directors of the 
Iowa Methodist Hospital, touched the hearts of 
everyone by his reference to other parents who 
had lost sons and with whom he and Mrs. Blank 
shared a common grief. It was his and Mrs. 
Blank’s hope, he said, that the Memorial they 
had created for their son would serve a long and 
useful purpose in ministering to the needs of 
children not only in the community but through- 
out the state as well. Mr. Wagner accepted the 
symbolic keys from Mr. Blank in the name of the 
Methodist Hospital, and Governor Hickenlooper 
gave an inspiring and understanding address in 
accepting the hospital for the people of Iowa. 

Dr. Morris Fishbein, Editor of the Journal of 
the American Medical Association, delivered the 
dedicatory address of the afternoon in his own 
rapid-fire, inimitable style. He praised the mod- 
ern construction of the hospital and pointed out 
the importance of its potentialities for research 
in advancing knowledge of the many problems 
still awaiting solutions in the field of child health, 
many of which he reviewed. 

Certainly this generous and far-sighted gift of 
Mr. and Mrs. Blank fills a much and long needed 
want for hospital care of children. Its' seventy- 
five bed capacity should mean that no sick child 
for miles around need lack institutional care 
whenever necessary. Its close association with 
a general hospital, giving it ready access to good 
laboratory, x-ray, .surgical, and consultative serv- 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


17 


ices, is in keeping with modern ideas of construc- 
tion of children’s hospitals. Besides the general 
beds located in small units, provision has been 
made for a contagious disease unit and for an out- 
patient department. These, together with the 
large newborn service of the main hospital, assure 
the essentials of a well rounded training in pe- 
diatrics for nurses, interns, and residents. 


COMPLETE FEEDING INTRAVENOUSLY 

Parenteral fluid therapy is assuming an ever 
increasing role of importance in the treatment of 
patients of all ages and all types. For years the 
customary solutions such as glucose, normal sa- 
line, and blood have been used. More recently 
plasma has been added to the group and has 
proved of tremendous benefit in the treatment of 
shock and shocklike conditions. Now, however, 
additional substances have appeared on the scene 
which, used in conjunction with other solutions, 
seem to make it possible to nourish a patient com- 
pletely for considerable periods of time even if 
nothing at all is given by mouth. 

The first recorded, complete intravenous feed- 
ing with fats, carbohydrates, and amino acids in 
proportions and quantities recommended in a 
normal infant’s diet was published in the No- 
vember 1944 issue of The Journal of Pediatrics 
by Helfrick and Abelson. A five month old infant 
with Flirschsprung’s disease became marantic and 
so emaciated that death seemed inevitable. Carbo- 
hydrate was supplied in 50 per cent glucose so- 
lution, amino acids (amigen) in a 10 per cent so- 
lution, and fat in a 10 per cent emulsion. The 
latter consisted of olive oil and lecithin in a 2:1 
ratio suspended in water. Fat globules were homo- 
genized and given further treatment to reduce 
their size and provide adequate dispersion of the 
particles. A total of 520 calories daily was sup- 
plied the infant, 58 per cent of which came from 
the carbohydrate, 12 per cent from amino acids, 
and 30 per cent from fat. This required the daily 
administration of 150 cubic centimeters of 50 per 
cent glucose, 150 cubic centimeters of 10 per cent 
amino acids, and 180 cubic centimeters of 10 
per cent fat emulsion. An additional 120 cubic cen- 
timeters of normal saline solution was given, mak- 
ing a total fluid intake of 600 cubic centimeters 
per day. It is not stated whether or not parenter- 
al vitamins were given, but this could have been 
readily done and if necessary minerals to meet the 
baby’s needs in this respect could have been sup- 
plied parenterally. The authors report that at 
the end of the five day period of intravenous nu- 
trition the baby’s condition had improved so much 


that oral feedings were possible and the baby was 
discharged home seventeen weeks after admis- 
sion, having gained 2,860 grams. 

The importance of this report lies in the sig- 
nificance it has for what may be possible in the 
near future in the way of parenteral therapy. Un- 
questionably, more thought and study should be 
given by those of us in active practice to the 
actual needs of the patient in the way of parenter- 
al fluids. While glucose and saline have their 
indications, now that so many other types of ma- 
terial for intravenous use are available selec- 
tion must be made with care. Whole blood still 
stands out pre-eminently for use where there 
has been loss of blood, and plasma is the fluid 
of choice in shock. Protein in the form of amino 
acid (amigen) is being found of great value by 
the surgeons in the pre- and postoperative care 
of patients where a hypoproteinemia is present. 
While fat is not yet available on the market for 
intravenous use, this report of Helfrick and Abel- 
son demonstrates its practicability, and in the 
near future total feeding by vein can be a practi- 
cal and life-saving procedure. 


ANNUAL CONFERENCE OF SECRETARIES 
AND EDITORS 

The annual conference of the secretaries and 
editors of the 48 state medical societies was held 
in Chicago November 17 and 18. The program 
was well chosen as to subject matter, and many 
physicians attended. 

Dr. James R. Bloss, chairman of the Board of 
Trustees of the American Medical Association, 
welcomed the group. Dr. Douglas L. Cannon, 
secretary of the Alabama society, was chosen pre- 
siding officer, and introduced Dr. Herman L. 
Kretschmer, President of the American Medical 
Association. Dr. Kretschmer said mediqal service 
plans were the main topic of conversation in most 
states he had visited, but that more education and 
information about them was needed, both as to 
their difficulties and their good points. He brought 
out the fact that because the span of life has been 
increased, there has been a corresponding increase 
in the degenerative diseases which has unjustly 
been blamed on lack of medical care. 

Dr. Roger I. Lee, President-Elect, next spoke 
on postwar medical service. He mentioned the 
questionnaires which had been sent to medical 
officers and the high percentage of replies received. 
Many of the younger officers wanted a chance for 
further internship, residency, or fellowship, and 
a survey of those opportunities is now being made. 
He said that conferences had been held with the 
result that the Veterans Administration will regard 


18 


Journal of Iowa State Medical Society 


January, 1945 


any medical officer, no matter what his age, as 
ha^■ing had liis training interrupted, and that he 
will therefore be eligible for further education 
under the G.T. hill of rights. The money allowed 
under this bill is not very much for a medical 
officer, and there has been a suggestion made that 
possibly the Army might retain him in service and 
give him a refresher course before discharging 
him. Tie also said the American Medical Associa- 
tion was going to establish an office of information. 

Lt. Col. Harold C. Lueth described this office of 
information, saying it was to provide information 
of medical education opportunities, information 
about licensure, and information of the medical, 
social, and economic phases of locations. He dis- 
tributed forms on which much of this ipformation 
could be tabulated, and also showed slides giving 
the results of the cjuestionnaires returned by 
medical officers. 

Dr. John H Fitzgibhon discussed the work of 
the Council on Medical Service and Public Rela- 
tions. saying it had been handicapped by not having 
a permanent secretary. He said the Council plan- 
ned to have regional meetings in the United States 
to acquaint the members with its functions. Among 
them he thought the Council might well undertake 
an evaluation of the medical service plans now in 
existence, that the plans could be strengthened by 
such conferences. 

Dr. McCinnis and Dr. Robinson of the Ameri- 
can Red Cross asked the opinion of the group 
about the future of the Red Cross blood donor 
program after the war. They said the Red Cross 
wanted to serve public health within the limits of 
its functions; that it was responsible for the 
safety of the volunteer donors, for the protection 
of the blood, and for the Red Cross money. It 
seemed to be the feeling of those present that the 
Red Cross can enroll the donors and carry out the 
administrative details, while the medical profes- 
sion, either through the medical society or the 
state departments of health, can take care of the 
technical end. 

Dr. E. D. Plass gave a thoughtful history of the 
development of the EMIC program, bringing out 
the fact that the method of payment was deter- 
mined by Congress. He said the program had 
meant a regimentation of clients into one class, 
that of ward service, and that it had meant a 
scrapping by the Children’s Bureau ,of ten years’ 
establishment of standards for prenatal care. Con- 
sequently, while the program may have meant bet- 
ter care for some mothers than they had had pre- 
viously, for many others it meant less care. 

Dr. Thurman B. Rice discussed the EMIC pro- 
gram from an administrative standpoint. He 


.said the act had been before Congress four limes 
and each time the vote for it has been overwhelm- 
ing. Most of the trouble lies with the Children’s 
Bureau which is definitely leftist inclined and 
breeds distrust. He brought out the fact that so 
far the program has cost $42,800,000, and has 
been a terrific mess administratively, so what 
would the Murray-Wagner-Dingell Bill with its 
much larger coverage be ? He ended by saying 
every state should talk to its congressmen about 
the matter. 

Dr. Robert E. S. Young, in discussing medical 
service plans, said a change in administration 
would have made no difference except to delay 
action ; that the need for prepayment exi.sts and 
will pi'evail. Nine-tenths of all families have one 
wage earner only, and one-half the poverty of 
this group is due to illness of the wage earner. 
Sixty-five per cent of the people in California 
wanted insurance. Eifteen million people are 
covered by Blue Cross, eighteen million by in- 
dustrial and commercial plans, so that already 
one-half of the population is covered by prepay- 
ment plans of some sort. Indigents and medical 
indigents will not be reached by prepayment in- 
surance, and the government is not interested in 
this problem. These people will get charity as 
they have in the past. Medical care varies with 
the locality, and the cost varies also. Plans for 
medical care are pregnant with political power. 
Industry has long recognized the value of medical 
control. Labor now realizes the value of a medical 
program and is much interested, but Dr. Young- 
felt it was impossible for industry, or the labor 
union, to develop a first class medical program 
because both want control of it. The medical pro- 
fession should do the job. 

He stressed the need for every physician to 
become familiar with the difference between in- 
demnity and service plans, the good and dangerous 
points of each. He dwelt on the experience of 
the Michigan plan and the part the CIO had 
played in it. He then told the different pro- 
posals made in Ohio and the dangers in each. 
He ended his talk with the statement that we 
need more doctors in the county societies who 
understand the principles of insurance ; we need 
county societies that will come to life and dis- 
cuss the problem. He said the program should 
start in medical schools, and that the medical 
student should be included in organized medicine, 
and stimulated to an interest in its problems. 

A representative from Michigan refuted some 
of Dr. Young’s statements about the plan, and 
a general discussion followed. 

The three papers given following the dinner 
Eriday evening were well prepared and con- 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


19 


structivc. Dr. Herman M. Jahr, editor of the 
Nebraska Stale Medical Journal, spoke of state 
journals as molders of opinion ; Dr. Creighton 
Barker, Secretary of the Connecticut State Med- 
ical Society, on the attitude of state medical jour- 
nals toward political and social trends that may 
affect medical affairs ; and Dr. E. M. Shanklin, 
Editor of the Journal of the Indiana State Med- 
ical Association, on state journals as news serv- 
ices. 

Saturday morning Dr. J. W. Wilce discussed 
the national fitness program, starting with the 
findings in the last war and the efforts made to 
overcome some of the physical defects by a phy- 
sical training program. Even so, the same find- 
ings occurred again in this war, and as a result a 
national committee has been appointed to try to 
bring about better physical fitness. Some phy- 
sicians say the movement is poorly timed because 
physicians are too busy now to work with it : 
that it is a movement that crops up, will run its 
course, and die. Others feel that something can 
be accomplished and that physicians should co- 
operate and direct such a program. A general 
discussion followed with many participating in it. 

Dr. A. S. Brunk closed the program by dis- 
cussing a radio program recently carried on in 
^Michigan. The State Society assessed each mem- 
ber $10.00, and with this it put on weekly five 
minute commercial programs over seven stations 
in different portions of the state. An advertising 
company was hired to prepare the script, and 
competent radio actors to play the different parts. 
Through this means the Society was able to pre- 
sent its views and policies to the public, and the 
response was gratifying. 


MINUTES OF MEETINGS OF STATE SOCIETY 
OFFICERS AND COMMITTEES 
Meeting of the Executive Council 
December 17, 1944 

The Executive Council of the Iowa State Medical 
Society met at the Hotel Fort Des Moines in Des 
Moines Sunday, December 17, 1944, at 10:00 a. m. 
with the following persons present: Drs. R. D. Bern- 
ard of Clarion, Robert L. Parker, James A. Downing, 
and 0. J. Fay of Des Moines, L. L. Carr of West 
Union, C. H. Cretzmeyer of Algona, J. B. Knipe of 
Armstrong, J. E. Reeder of Sioux City, E. F. Beeh 
of Fort Dodge, J. C. Hill and J. W. Billingsley of 
Newton, H. A. Householder of Winthrop, C. A. Boice 
of Washington, R. C. Gutch of Chariton, J. G. Macrae 
of Creston, and W. A. Sternberg of Mt. Pleasant. 

The meeting was called to order by the president- 
elect, Dr. Bernard, at 10:15 a. m. After discussion, 
it was voted that the NPC committee be continued 
and that it report to the next House of Delegates 
meeting with a resolution which will give the dele- 


gates to the American Medical Association something 
by which to be guided. 

Directors to serve until the incorporation of Iowa 
Medical Service were appointed, and the meeting ad- 
journed at 11:50 a. m. 


Meeting of the Cancer Committee 
December 17, 1944 

The Cancer Committee of the Iowa State Medical 
Society met at the Hotel Fort Des Moines in Des 
Moines Sunday, December 17, 1944, with the follow- 
ing persons present: Drs. L. L. Carr, C. H. Cretz- 
meyer, J. B. Knipe, J. E. Reeder, E. F. Beeh, J. C. 
Hill, H. A. Householder, C. A. Boice, R. C. Gutch, 
J. G. Macrae, A. W. Erskine, H. W. Morgan, E. G. 
Zimmerer, J. W. Billingsley, and R. D. Bernard. 

Meeting was called to order by the chairman. Dr. 
Reeder, at 11:50 a. m. and the utilization or non- 
utilization of tumor clinics was discussed, as was 
the need for legislation making wider utilization pos- 
sible. It was voted that the Cancer Committee 
should draw up a bill to be given to the Legislative 
Committee for study, and to the State Department 
of Health for its approval, and then an effort be 
made to get it passed in the coming session of the 
Legislature. 

It was also voted that the Cancer Committee ap- 
prove the full time employment of someone by the 
Field Army to head its work. Meeting adjouimed at 
12:30 p. m. 


Meeting of the Fee Committee 
December 17, 1944 

The special committee appointed by the Speaker 
of the House to draw up a fee schedule for Iowa 
Medical Service met at the Hotel Fort Des Moines 
in Des Moines Sunday, December 17, 1944, with the 
following physicians present: R. N. Larimer of Sioux 
City, chairman; B. C. Boston of Waterloo, B. J. 
Dierker of Fort Madison, H. A. Weis of Davenport, 
L. A. Taylor of Ottumwa, F. W. Mulsow and Flor- 
ence Johnston of Cedar Rapids, A. F. O’Donoghue of 
Sioux City, H. E. Farnsworth of Storm Lake, L. A. 
Coffin of Farmington, J. W. Billingsley of Newton, 
R. D. Bernard of Clarion, H. M. Pahlas of Dubuque, 
E. C. McClure of Bussey, J. S. Gaumer of Fairfield, 
and F. W. Fordyce, T. A. Burcham, J. A. Downing, 
C. W. Losh, and Martin I. Olsen of Des Moines. 

The committee discussed fees for the many proce- 
dures involved in the plan and arrived at definite fig- 
ures. Meeting adjourned at 3:30 p. m. 


DR. BERNARD TO HEAD NORTH CENTRAL 
CONFERENCE 

Dr. R. D. Bernard of Clarion, President-Elect of 
the Iowa State Medical Society, was honored by 
being elected president of the North Central Con- 
ference at its annual meeting in St. Paul December 
10. The North Central Conference is an informal 
organization of representatives from Wisconsin, 
Minnesota, North and South Dakota, Nebraska and 
Iowa, and meets annually in St. Paul. 


20 


jouKXAi. OK Iowa State Medical Society 


January, 1945 


I)K. STERN HER(; HONORED 

Dr. W. A. Sternberg’ of Mt. Pleasant, a member 
of the Board of Trustees of the Iowa State Medical 
Society, •was named president-elect of the Mississippi 
Valley Medical Society at the annual directors meet- 
ing in Quincy, Illinois. He will take office in 1946. 
Others elected were Dr. L. H. Jorstad, St. Louis, 
Missouri, first vice president; Dr. E. E. Nystrom, 
Peoria, Illinois, second vice president; Dr. E. J. 
Lessenger, New London, Iowa, third vice president; 
and Dr. Harold Swanberg, Quincy, Illinois, secretary- 
treasurer. Dr. Grayson L. Carroll of the St. Louis 
University School of Medicine was installed as 
president for the 1945 term. 


AMERICAN COLLEGE OF SURGEONS 
ANNOUNCES 1944 APPROVED' LIST 
OF HOSPITALS 

The American College of Sui’geons announces that 
3,152 hospitals in the United States and Canada are 
included in the 1944 Approved List. The list is pub- 
lished in the annual Approval Number of the College 
Bulletin issued December 31. 

There were 3,911 hospitals included in the 1944 
survey, and the approved hospitals represent 80.6 
per cent. The first annual survey in 1918 included 
692 hospitals of 100 beds or over, of which only 89 
or 12.8 per cent merited approval. Hospitals of 25 
beds and over are covered in the current surveys. 

On the 1944 survey list there was a total of 2,342 
hospitals of 100 beds and over, and 2,182 or 93.1 per 
cent were approved. There were 1,119 hospitals of 
50 to 99 bed capacity under survey, of which 789 or 
70.3 per cent were approved, and 450 hospitals of 
25 to 49 bed capacity, of which 181 or 40.2 per cent 
were approved. 

On December 31 of each year the ratings of hos- 
pitals under survey by the American College of 
Surgeons automatically terminate. The status of 
every hospital based upon all data collected from the 
current survey is reconsidered each year. 


ANNUAL MARCH OF DIMES 

Forty-three prominent industrial and civic leaders 
have been appointed as state chairmen for the March 
of Dimes and will direct the Fund-Raising Appeal 
of The National Foundation for Infantile Paralysis, 
January 14 to 31, in their states, according to an 
announcement made by Basil O’Connor, Foundation 
President. Thirty-four of the chairmen who will 
direct the appeal in their states served in a similar 
capacity last year. Among the new chairmen ap- 
pointed was Mr. E. Lee Keyser of Des Moines, who 
will direct the 1945 appeal in Iowa. 

Although the infantile paralysis epidemic of 1944, 
with nearly 19,000 cases already reported, was the 
second largest in the recorded history of the disease 
in the United States, the nation was better prepared 
for the march of the Crippler than ever before, 


through the generosity of the American people 
whose dimes and dollars helped to stem the tide of 
the mysterious poliomyelitis for which there is no 
known preventive and no cure. 

Epidemic areas in 1944 included North Carolina, 
New York, Kentucky, Ohio, Virginia, Pennsylvania 
and Michigan. Poliomyelitis also severely affected 
Tennessee, Maryland, Indiana, Louisiana, New Jer- 
sey, Mississippi, Connecticut and District of Colum- 
bia. 


MICHIGAN SURVEY 

The Michigan Health Council recently conducted 
a survey of 4,968 persons, a representative cross 
section of the population, to determine the public’s 
attitude toward the medical profession, and to esti- 
mate the degree to which the idea of socialized 
medicine has been accepted by the people of the 
state. Undoubtedly a survey in Iowa would give 
practically the same results. Some of the questions 
and answers may be of interest, and are given for 
your information. 

1. What is your opinion of doctors of medicine? 

As a group do you think they are doing a good job 
for the public? Yes — 91.6%; No — 4.2%; Don’t 

Know — 4.2%. 

2. In case of an ordinary operation, would you 
prefer to have your regular doctor or would you 
prefer to have a specialist? Regular Doctor — 56.5%; 
Specialist — 38.4%; Don’t Know — 5.1%. 

3. Do you believe medical doctors are as honest 
as they should be in all dealings with patients? 
Yes — 60.8%; No — 28.0%; Don’t Know — 11.2%. 

4. Do you think you pay too much, too little, or 
the right amount for medical doctors? Pay too 
much — 20.5%; Too Little — 1.2%; The Right Amount 
—68.9%. 

5. Do you think we should have some sort of a 
government operated medical hospital plan? Yes 
—38.7%; No— 42.8%; Don’t Know, 18.5%. 

6. If you were asked to choose between one of these 
plans for medical hospital care, which would you 
prefer ? 

Voluntary, professionally-sponsored.. 33.7% 


Present private practice 26.6% 

Government-controlled 15.5% 

Regular insurance 13.4% 

Union-controlled 9% 

Don’t know 9.9% 


7. How did you select your present medical doc- 
tor? Personal recommendation by a friend, a rela- 
tive, or other medical men influenced 37% of the 
people when choosing their medical doctor. Fifteen 
per cent of the people made their choice because of 
the doctor’s reputation, and 14% retained their 
“family doctor.” Eleven per cent said their doctor 
had been selected by chance: from the telephone 
book, building directory, or just because the loca- 
tion was convenient. 


VoL. XXXV, Xo. 1 


Journal of Iowa State ^Medical Society 


21 


As of December 23, 1944 


Adair County 

Cornell, D. D., Greenfield (APO 41, San Francisco, 

Cal.) Capt., A.U.S. 

Gantz, A. J., Greenfield (APO 951, San Francisco, 

Cal.) Capt., A.U.S. 

Adams County 

Bain, C. L., Corning (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Willett, W. J., Carbon (APO 230, New York, N. Y.).Capt., A.U.S. 

Allamakee County 
Hogan, P. W., Waukon 
Ivens, M. H., Waukon (Camp Shelby, La.) 

Kiesau, M. F., Poetville (Jefferson Barracks, Mo.).. Major, A.U.S. 

Rominger, C. R., Waukon (Camp Claiborne, La.) A.U.S. 

Appanoose County 

Condon. F. J.. Centerville (Owensboro, Ky.).. Major, U.S.P.H.S. 

Edwards, R. R.. Centerville (Richmond, Va.) Capt., A.U.S. 

Huston, M. D., Centerville (Camp Bowie. Texas) . .Capt., A.U.S. 
Audubon County 

Koehne, F. D., Audubon (APO 520, New York, 

N. Y.) Major, A.U.S. 

Benton County 

Koontz, L. W., Vinton (APO 7. San Francisco, Cal.) Capt., A.U.S. 
Senfeld, Sidney, Belle Plaine 

Black Hawk County 

Bickley, D. W., Waterloo (APO New York. N. Y.) .Capt., A.U.S. 
Bickley, J. W., Waterloo (APO 956, San PYancisco, 

Cal.) Capt., A.U.S. 

Butts. J. H., Waterloo (Galveston, Texas) Comdr., U.S.N.R 

Cooper, C. N., Waterloo (Ottumwa, Iowa) . .Lt. Comdr., U.S.N.R. 
Ericsson, M. (3., Cedar Falls (Camp Barkeley, Tex.) Capt., A.U.S. 
Hartman, H. J., Waterloo (APO 33, San Francisco, 

Cal.) Capt., A.U.S. 

Henderson, L. J., Cedar Falls (APO 782, 

New York, N. Y.) Major, A.U.S. 

Hoyt, C. N., Cedar Falls (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Ludwick, A. L., Waterloo (Abilene, Texas) Major, A.U.S. 

Marquis, F. M„ Waterioo (APO 17321, New York, 

N. Y.) Capt., A.U.S. 

O’Keefe. P. T„ Waterloo (APO 79, New York, 

N. Y.) Capt., A.U.S. 

Paige, R T., LaPorte City (Banana River, Fla.) .Comdr., U.S.N.R. 
Rohlf, R L., Jr., Waterloo (APO 230, New York, 

N. Y.) Major, A.U.S. 

Seibert, C. W., Waterloo (Colorado Springs, Colo.) . .Major, A.U.S. 
Smith, E. E., Waterloo (APO 709, San Francisco, Cal.) 

Major, A.U.S. 

Smith, R I., Waterloo (Milwaukee, Wis.) Capt., A.U.S. 

Smith, R G., Cedar Falls (APO 612, New York, 

N. Y.) Major, A.U.S. 

Trunnell, T. L., Waterloo (Parris Island, S. Car.) . . .Lt. U.S.N.R. 
Boone County 

Brewster. E. S., Boone (APO 446, New York, N. Y.) .Major, A.U.S. 

Healy, M. J., Boone ((lamp Chaffee, Ark.) Capt., A.U.S. 

Shane. R. S., Pilot Mound (Des Moines, la.) Lt. Col., A.U.S. 

Bremer County 

Blum, O. S., Waver ly (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Rathe, H. W., Waverly (APO 209, New York, N. Y.) 

Major, A.U.S. 

Shaw, R E., Waverly (Long Beach, Cal.) 1st Lt., A.U.S. 

Buchanan County 

Barton, J. C., Independence (APO 314, New York, 

N. Y.) ,Lt. Col., A.U.S. 

Hersey, N. L., Independence (Fleet PO, San Francisco, 

Cal) Lt. Comdr., U.S.N.R. 

Leehey, P. J., Independence (APO 957, San Francisco, 

Cal.) Capt., A.U.S. 

Loeck, J. F., Aurora (APO 9787, New York, N. Y.) . .Capt., A.U.S. 

Buena Vi.sta County 

Almquist, R E., Albert City (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Brecher, P. W., Storm Lake (Camp Adair, Ore.)..Lt, Col., A.U.S. 

Hansen, R R., Storm Lake (Farragut, Idaho) Lt., U.S.N.R. 

Mailliard, R. E., Storm Lake (APO 254, New York, 

N. Y.) Lt. Col., A.U.S. 

Shope, C. D., Storm Lake (Fort Des Moines, la.) . .Capt., A.U.S. 
Witte. H. J., Marathon (Fort Crook, Nebr.) Major, A.U.S. 

Butler County 

Andersen, B. V., Greene (Fleet PO, Seattle, Wash) .Lt., U.S.N.R. 
James, R. A., Allison (Mare Island, Cal.) 

Rolfs, F. O., Parkersburg (Springfield, Mo.) 1st Lt., A.U.S. 

Calhoun County 

Grinley, A. V., Rockwell City (APO 350, New York, 

N. Y.) ....Capt., A.U.S. 

Hobart, F. W., Lake City (Camp Grant, 111.) Capt., A.U.S. 

McVay, M. J.. Lake City (Waco, Texas) Capt., A.U.S. 


Peek. L. H.. Lake City (Jefferson Barracks, Mo.) . .Capt., A.U.S. 

Stevenson, W. W., Rockwell City (Fleet PO, San 
Francisco, Cal.) Lt. Comdr., U.S.N.R. 

Weyer, J. J., Lohrville (APO 465, New York, 

N. Y.) Capt., AU.S. 

Carroll County 

Anneberg, A. R., Carroll (Camp Barkeley, Texas) A.U.S. 

Anneberg, W. A., Carroll (APO 367, New York, 

N. Y.) Capt., A.U.S. 

Cochran, J. L., Carroll (Gulfport, Miss.) 

Cross. D. L., Coon Rapids (Fleet PO, San Francisco, 

Cal.) Lt.. U.S.N.R. 

Freedland, Maurice, Coon Rapids 

Morrison, J. R., Carroll (Ft. Dix, N. J.) Capt., A.U.S. 

Morrison, R. B., Carroll (APO 634, New York, 

N. Y.) Capt., A.U.S. 

Pascoe, P. L.. Carroll (Bowman Field, Ky.) Capt., A.U.S. 

Scannell, R. C., Carroll (Denver, Colo.) Capt., A.U.S. 

Tindall, R. N., Coon Rapids (Hines, 111.) Major, A.U.S. 

Wyatt, M. R., Manning (De Ridder, La.) Capt., A.U.S. 

Cass County 

Egbert, D. S., Atlantic (APO 218, New York N. Y.) 

Major. A.U.S. 

Needles, R. M., Atlantic (APO 131, New York, 

N. Y.) Capt., A.U.S. 

Petersen. M. T., Atlantic (Topeka, Kan.).l Capt., A.U.S. 

Schiff, Joseph, Anita (Walla Walla, Wash.) 1st Lt., A.U.S. 

Cedar County 

Laughlin, R. M., Tipton (San Diego, Cal.) Lt., U.S.N.R. 

Mosher, M. L., West Branch (APO 560, New York, 

N. Y.) Capt., A.U.S. 

O’Neal, H. E., Tipton (Camp Maxey, Texas) Lt. Col., A.U.S. 

Ccrro Gordo County 

Adams, C. O., Mason City (Vancouver, Wash.) Capt., A.U.S. 

Egloff, W. C., Mason City (APO 17130, New York, 

N. Y.) Capt A.U.S. 

Flickinger, R. R., Mason City (’Tuscaloosa, Ala.) ... .Capt., A.U.S. 

Hale, A. E„ Dougherty (Atlanta, Ga.) Capt., A.U.S. 

Harris, R. H., Mason City (Dyersburg, Tenn.) Capt., A.U.S. 

Harrison, G. E., Mason (3ity (APO 365, New York. 

N. Y.) Col., A.U.S. 

Houlahan, J. E., Mason City (APO 838, New Orleans, 

La.) Capt., A.U.S. 

Lannon, J. W., Clear Lake (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Long, D. L., Mason City (APO 520, New York, 

N. Y.) Capt., A.U.S. 

Morgan, P. W., Mason City (Camp Butner, 

N. Car.) Capt., A.U.S. 

Marinos, H. G., Mason City (APO 25. San Francisco, 

Cal.) Capt., A.U.S. 

Sternhill, Irving, Mason City (Ayer, Mass.) Capt., A.U.S. 

Cherokee County 

Bullock, G. D., Washta (APO 17583, New York, 

N. Y.) Capt., A.U.S. 

Ihle, C. W., Jr., Cleghom (APO 6, San Francisco, 

Cal.) Major, A.U.S. 

Swift. C. H., Jr., Marcus (APO 201, San Francisco. 

Cal.) Capt.. A.U.S. 

Chickasaw County 

Caulfield, J. D., New Hampton (APO 178, New York, N. Y.) 

Major, A.U.S. 

Murphey, A. L., Fredericksburg (APO 3470, San 
Francisco, Cal.) Capt., A.U.S. 

O’Connor. E. C., New Hampton (Redmond, Ore.) .. .Capt., A.U.S. 

Richmond. P. C., New Hampton (APO 88. New York, 

N. Y.) Major, A.U.S. 

Clarke County 

Armitage. G. I., Murray (Carlisle Barracks, Pa.) . .1st Lt., A.U.S. 

Clay County 

Edington, F. D., Spencer (APO 629, New York, 

N. Y.) Coh.A.U.S. 

Jones, C. C., Spencer (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

King, D. H., Spencer (Peterson Field. Colo.) Capt., A.U.S. 

Clayton County 

Anderson, H. M., Strawberry Point (Springfield, 

Mo.) Capt., A.U.S. 

Glesne, O. G., Monona (Knoxville, Iowa) Capt., A.U.S. 

Rhomberg, E. B., Guttenberg (APO 684, New York, 

N. Y.) Capt., A.U.S. 

Clinton County 

Amesbury, H. A., Clinton (Vancouver, Wash.) Capt., A.U.S. 

Burke, J. C.. Clinton (Great Bend, Kan.) A.U.S. 

Ellison, G. M., Clinton (APO 9030, New York, 

N. Y.) Capt., A.U.S. 

Hill, D. E.. Clinton (APO 9787, New York, N. Y.) . . .Capt., A.U.S. 

King, R. C., Clinton (APO 403, Now York, N. Y.)...Capt. A.U.S. 


22 


Joi KNAL OF Iowa State IMedical Society 


January, 1945 


Lenaehan, It. T., Clinton (Fleet PO, San Fran- 
cisco. Cal.) Lt. Comdr., U.S.N.R. 

Norment, J. E., Clinton (Washington, D. C.) 

Lt. Comdr., U.S.N.R. 

Riedesel, E. V., Wheatland (Fort Douglas, Utah) 

Scanlan, G. C., DeWitt (Carlisle Barracks, Pa. ) . . . .Capt., A.U.S. 

Snyder, D. C., De Witt 

Speigel, I. J., Clinton (Galesburg, 111.) Capt., A.U.S. 

Van Epps, E. F., Clinton (APO 9921, New York, 

N. Y.) Capt., A.U.S. 

Waggoner, C. V., Clinton (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Wells, L. L., Clinton (APO 17172 New York, N. Y.) .Capt., A.U.S. 

Crawford County 

Fee, C. H., Denison (APO 696. New York. N. Y.) .Major, A.U.S. 

Grau. A. H.. Denison, (Fleet PO, San Francisco. 

Cal.) Lt. Comdr., U.S.N.R. 

Maire, E. J., Vail (Camp Howze, Tex.) Capt., A.U.S. 

Wetrich, M. F., Manilla (APO 986, Seattle, Wash.) . .Capt., A.U.S 
Dnllaa-Guthrie Counties 

Butterfield. E. T., Dallas Center (Fort Sheridan, 

111.) 1st Lt., A.U.S. 

Byrnes, A. W., Guthrie Center (Fort Custer. Mich.) .Major. A.U.S. 

Fail, C. S.. Adel (Fleet PO, San Francisco, Cal.) Lt., U.S.N.R. 

Margolin, J. M.. Perry (APO 5816, New York, 

N. Y.) Capt., A.U.S. 

McGilvra, R. I., Guthrie Center (Ames, Iowa) Lt., U.S.N.R. 

Mullmann, A. J., Adel (APO 17558, San Fran- 
cisco, Cal.) i. . .Capt., A.U.S. 

Nicoll. C. A., Panora (APO 17351, New York, 

N. Y.) Capt., A.U.S. 

Osborn, C. R., Dexter (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Todd, D. W., Guthrie Center (APO 2, New York, 

N. Y.) Capt., A.U.S. 

Wilke, F. A., Woodward Capt., A.U.S. 

Davis County 

Fenton, C. D., Bloomfield (APO 5253, New York, 

N. Y.) Capt., A.U.S. 

Gilfillan, G. W„ Bloomfield (Fleet PO, San Francisco, 

Cal.) .Lt. Comdr., U.S.N.R. 

Decatur County 

Garnet, E. E., Lamoni (APO New York, N. Y.) .,. .Capt., A.U.S. 

Delaware County 

Baumgarten, Oscar, Earlville (APO 689, New York, 

N. Y.) ..Capt., A.U.S. 

Clark, R E., Manchester (APO 419, New York, N. Y.) 

Capt., A.U.S. 

Des Moines County 

Eigenfeld, M. L., Burlington (Cleveland, Ohio) ... 1st Lt., A.U.S. 

Heitzman, P. O., Burlington (Fort Baker, Cal.) Capt., A.U.S. 

Jenkins. <3. D., Burlington (West Point, N. Y.) . . .Lt. Col., A.U.S. 

Lohmann, C. J., Burlington (APO 708, San Fran- 
cisco, Cal.) Major, A.U.S. 

McKitterick, J. C., Burlington (Hamilton, 

R. I.) Comdr., U.S.N.R. 

Moerke, R. F., Burlington (APO 9641, San Francisco, 

Cal.) ,CapL, A.U.S. 

Sage, E. C., Burlington (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Dickinson County 

Buchanan, J. J., Milford (Santa Ana, Cal.) Lt., U.S.N.R. 

Henning, G. G., Milford (APO 96, San Francisco, 

Cal.) Major, A.U.S. 

Nicholson, C. G., Spirit Lake (Sawtelle. Cal.) Capt., A.U.S. 

Rodawig, D. F., Spirit Lake Major, A.U.S. 

Dubuque County 

Anderson, E. E., Dubuque (Bradley Field, Conn.) .. .Capt., A.U.S, 

Beddoes, M. G„ Cascade (APO 709, San FYancisco, 

Cal.) Capt., A.U.S. 

Conzett, D. C., Dubuque (APO 887, New York, 

N. Y.) LL Col., A.U.S. 

Cunningham, J. C., Dubuque (Fairfield, Ohio) Capt., A.U.S. 

Edstrom, Henry, Dubuque (APO 645, New York, N. Y.) 

Major, A.U.S. 

Entringer, A. J., Dubuque (APO 41, San Francisco, 

Cal.) Capt., A.U.S. 

Hall, C. B., Dubuque (Camp Shelby, Miss.) Capt., A.U.S. 

Knoll, A. H.-, Dubuque (San Francisco, Cal.) Major, A.U.S. 

Langford, W. R., Epworth (Miami Beach, Fla.) .... Capt., A.U.S. 

Lavery, H. B., Dubuque (Washington, D. C.) Lt. Col., A.U.S. 

Leik, D. W., Dubuque (Wichita Falls, Tex.) Capt., A.U.S. 

Mueller, J, J., Dubuque (APO 230, New York, N, Y.) .Capt., A.U.S. 

Olson, P. F., Dubuque (Mare Island, Cal.) . .Lt. Comdr., U.S.N.R. 

Painter, R. C., Dubuque (Salt Lake City, Utah) ... .Lt., U.S.N.R. 

l^aulus, J. W., Dubuque (APO 115, New York, 

N. Y.) Capt., A.U.S. 

Plankers, A. G., Dubuque (APO 363 New York, 

N. Y.) Major, A.U.S. 

Quinn. E. P., Dubuque (Brentwood. L. I.) Major, A.U.S. 

Scharle, Theodore, Dubuque (APO 17670, New York, 

N. Y.) Capt., A.U.S. 

Schueller, C. J., Dubuque (APO 758, New York, 

N. Y,) 1st Lt., A.U,S, 

Sharpe, D. C., Dubuque (APO 6541, New York, 

N. Y.) Major, A.U.S. 

Smith, C. W„ Dubuque (Shoemaker, Cal.) Lt., U.S.N.R. 

Steffens, L. F., Dubuque (Camp Chaffee, Ark.) .., Lt. Col., A.U.S. 

Straub, J. J., Dubuque (Corpus Christi, Texas) ... .Lt., U.S.N.R. 

Ward, D. F., Dubuque (Great Lakes, 111.) . . . .Lt. Comdr., U.S.N.R. 


Emmet County 

Clark. J. P.. Estherville (APO New York, N. Y.) . .Capt., A.U.S. 

Collins, L. E., Estherville (Camp Dodge, Iowa) A.U.S. 

Miller, O. H., Estherville (Seattle. Wash.)..Lt. Comdr., U.S.N.R. 

Fayette County 

Gallagher, J. P., Oelwein (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Henderson, W. B., Oelwein (St. Louis, Mo.) Lt Col., A.U.S. 

Sulzbach, ,1. F., Oelwein 

Walsh. W. E., Hawkeye (Port Chicago, Cal.) Lt. Comdr., U.S.N.R. 

Floyd County 

Baltzell, W. C., Charles City (APO 2. New York, 

N. Y.) Major, A.U.S. 

Flater, N. C., Floyd (APO 360. New York, N. Y.) .Capt., A.U.S. 

Knight, R. A., Rockford (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Mackie. D. G., Charles City (APO 493, New York, 

N. Y.) Capt., A.U.S. 

Miner, J. B„ Jr., Charles City (San Diego, Cal.) .. .Lt., U.S.N.R. 

Tolliver, H. A., Charles City (APO 91, New York, N. Y.) 

Capt., A.U.S. 

Franklin County 

Byers, W. L., Sheffield (Jefferson Barracks, Mo.) 1st Lt., A.U.S. 

Hedgecock, L. E., Hampton (Camp Lejeune, 

N. Car.) Lt. Comdr., U.S.N.R. 

Randall, W. L., Hsimpton (Oceanside, Cal.) Lt., U.S.N.R. 

Walton, S. G., Hampton (APO New York, N. Y.) .. .Capt., A.U.S. 

Fremont County 

Kerr, W. H.. Hamburg (Camp Phillips, Kan.) Capt., A.U.S. 

Marrs, W. D., Tabor (Ardmore, Okla.) Capt., A.U.S. 

Powell. R. A., Farragut (Great Lakes, 111.) .. .Lt. (jg), U.S.N.R. 

Wanamaker, A. R.. Hamburg (APO 939, Seattle. 

Wash.) Capt., A.U.S. 

Greene County 

Cartwright, F. P„ Grand Junction (APO 511, New York, 

N. Y.) Capt., A.U.S. 

Castles, W. A., Rippey (APO 958, San Francisco, Cal.) 

Major, A.U.S. 

Hanson, L. C„ Jefferson (APO 728, New York, N. Y.) 

Capt., A.U.S. 

Jongewaard, A. J., Jefferson (Fleet PO, San 

Francisco, Cal.) Lt. Comdr., U.S.N.R. 

Limburg, J. I.. Jr., Jefferson (APO 603, San Francisco, 

Cal.) Major. A.U.S. 

Lohr, P. E., Churdan (Hastings, Nebr.) Lt., U.S.N.R. 

Grundy County 

Cullison, R. M., Dike (Fort Howard. Md.) Major, A.U.S. 

Rose, J. E., Grundy Center (Fleet PO, New York, 

N. Y.) Lt. Comdr., U.S.N.R. 

Hamilton County 

Buxton, 0. C., Webster City (APO 9921, New York, 

N. Y.) 1st Lt.. A.U.S. 

Howar, B. F.. Jewell (APO 514, New York, N. Y.) Major, A.U.S. 

James, D. W., Kamrar (APO 782, New York, N. Y.) 
Capt,, A.U.S. 

Lewis, W. B., Webster City (APO 383, New York, 

N. Y.) Major, A.U.S. 

Mooney, F. P., Jewell (London, England) Capt., R.A.M.C. 

Paschal, G. A., Williams (Camp Barkeley, Texas) . .Capt.. A.U.S. 

Patterson, R. A., Webster City (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

Ptacek, J. L., Webster City (APO 12845 G, New York, 

N. Y.) Capt., A.U.S. 

Schrader, M. A., Webster City (Topeka, Kan.).... 1st Lt., A.U.S. 

Thompson, E. D., Webster City (Biloxi. Miss.) Capt., A.U.S. 

Hancock-Winnebago Counties 

Dolmage, G. H., Buffalo Center (Nashville, Tenn.) . .Capt., A.U.S. 

Dulmes, A. H., Klemme (APO 1778, New York, 

N. Y.) Capt., A.U.S. 

Eller, L. W., Kanawha (APO 302, New York, 

N. Y.) Capt., A.U.S. 

Irish, T. J., Forest City (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Shaw, D. F., Britt (Delhart, Tex.) Major, A.U.S. 

Thomas, C. W., Forest City (Camp Crowder, Mo.) . .Capt., A.U.S. 

Hardin County 

Burgess, A. W., Iowa Falls (Jacksonville, Fla) Lt., U.S.N.R. 

Houlihan, F. W., Ackley (APO 860, New York, 

N. Y.) 1st Lt., A.U.S. 

Jansonius, J. W„ Eldora (APO 4834, New York, 

N. Y.) Capt., A.U.S. 

Johnson. R. J., Iowa Falls (APO 614, New York, 

N. Y.) Capt. A.U.S. 

Johnson, W. A., Alden (Orlando, Fla.) Capt., A.U.S. 

Shurts, J. J., Eldora (Camp Roberts, Cal.) 1st Lt., A.U.S. 

Steenrod, E. J., Iowa Falls (Fleet PO, San Francisco, 

Cal.) Lt, U.S.N.R. 

Todd, V. S., Eldora (APO 9641, San Francisco, Cal.) Capt, A.U.S. 

Harrison County 

Bergstrom, A. C., Missouri Valley (Ft. Ord, Cal.) .. .Capt., A.U.S. 

Burbridge, G. E., Logan (APO 511, New York, 

N. Y.) Major, A.U.S. 

Byrnes. C. W., Dunlap (APO 980, Seattle, Wash.) . .Capt, A.U.S. 

Heise, C. A., Jr., Missouri Valley (Fleet PO, San 
Francisco, Cal.) Lt, U.S.N.R. 

Tamisiea, F. X., Missouri Valley (APO 662, New York, 

N. Y.) Capt, A.U.S. 

Henry County 

Brown, W. B., Mount Pleasant (APO 671, New York, 

N. Y.) Major, A.U.S. 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


23 


Dwankowski, Carl. Mt. Pleasant (APO 511, 

New York, N. Y.) Capt., A.U.S. 

Gloeckler, B. B., Mount Pleasant (APO 9768, New York, 

N. Y.) Capt., A.U.S. 

Hartley, B. D.. Mount Pleasant (APO 17130, New 

York. N. Y.) Capt., A.U.S. 

Megorden, W. H.. Mount Pleasant (Ogden, Utah) .. Capt., A.U.S. 

Ristine, L. P., Mount Pleasant (APO 9648, New York, 

N. Y.) Major. A.U.S. 

Howard CountT 

Buresh, Abner, Lime Springs (Fleet PO, San Francisco, 

Cal.) Lt„ U.S.N.R. 

Nierling, P. A., Cresco (APO 43. San Francisco. 

Cal.) Capt., A.U.S. 

Humboldt County 

Arent, A. S., Humboldt (Stockton. Cal.) Capt., A.U.S. 

Coddington, J. H., Humboldt (Oklahoma City, Okla.) .Capt., A.U.S. 

Ida County 

Dressier, J. B., Ida Grove (APO 713, Unit 2, San Fran- 
cisco. Cal.) ■ Capt., A.U.S. 

Martin, J. W., Holstein (Seymour, Ind.) Capt., A.U.S. 

Iowa County 

McDaniel, J. D., Marengo (Fort Ord, Cal.) Capt., A.U.S. 

Miller, D. F., Williamsburg (Fleet PO, San FYan- 

cisco. Cal.) Lt., U.S.N.R. 

Jackson County 

Swift, F. J., Jr., Maquoketa (APO 652, New York, 

N. Y.) Major, A.U.S. 

Jasper County 

Doake, Clarke, Newton 1st Lt., A.U.S. 

Minkel, R. M., Newton (APO New York, N. Y.) .. Major, A.U.S. 

Ritchey. S. J.. Newton Major, A.U.S 

Jetlerson County 

Castell, J. W., Fairfield (APO 9907, New York, 

N. Y.) Capt., A.U.S. 

Frey, Harry, Fairfield (Norfolk, Va.) Lt. Comdr., U.S.N.R. 

Gittler. Ludwig, Fairfield Lt. Col.. A.U.S. 

Graber, H. E., Fairfield Galesburg, 111 Major, A.U.S. 

Taylor, I. C.. Fairfield (Washington, D. C.) 1st Lt., A.U.S. 

Juhn.son County 

Agnew, J. W., Iowa City (Fort Lewis, Wash.) Capt., A.U.S. 

Albert. S. M., Iowa City (Camp White, Ore.) 1st Lt., A.U.S. 

Allen, J. H., Iowa City (Scott Field, 111.) Major, A.U.S. 

Anderson, E. N.. Iowa City (APO 647, Nerw York, 

N. Y.) Major, A.U.S. 

Boyd, E. J., Iowa City (Tampa, Fla.) Capt., A.U.S. 

Brinkhous. K. M., Iowa City (APO 4672, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Bunge, R. G., Iowa City (Biloxi, Miss.) 1st Lt., A.U.S. 

Callahan, G. D., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R 

Cobum, F. E„ Iowa City (Toronto, Canada) Capt., R.C.A. 

Cooper, W. K„ Iowa City (Mitchell Field, N. Y.) ... .Capt., A.U.S. 

Crowell, E. A., Iowa City (Ft. Geo. Wright, Wash.) .Capt., A.U.S. 

Diddle, A. W„ Iowa City (Fleet PO, San FYancisco, 

Cal.) Lt., U.S.N.R. 

Dorner, R A., Iowa City (APO 534, New York, 

N. Y.) Capt., A.U.S. 

Elmquist, H. S., Iowa City (San Diego, Cal.) .Lt. Comdr., U.S.N.R 

Emmons, M. B., Iowa City (Abilene, Texas) Capt., A.U.S. 

Flax, Ellis, Iowa City (APO 5833, New York, N. Y.) 1st Lt., A.U.S. 

Flynn, J. E.. Iowa City (Hot Springs. Ark.) Major, A.U.S. 

Fourt, A. S., Iowa City (APO 34, New York, 

N. Y.) Lt. Col., A.U.S. 

Francis, N. L., Iowa City (Annapolis, Md.) Lt. (jg), U.S.N.R. 

Galinsky, L. J., Oakdale (Camp Crowder, Mo.) Capt., A.U.S. 

Garlinghouse, R. O.j Iowa City (APO 302, New York, 

N. Y.) Major, A.U.S. 

Hardin, R. C., Iowa City (APO 508, New York, 

N. Y.) Major, A.U.S. 

Hartung, Walter, Iowa City (Camp Carson, Colo.) . .Capt., A.U.S. 

Hessin, A. L., Iowa City (APO 452, New York, 

N. Y.) Capt,, A.U.S. 

Irwin, R. L., Iowa City (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

January, L. E., Iowa City (Pyote, Texas) Major, A.U.S. 

Kanealy, J. F., Iowa City (APO 928, San Francisco, 

Cal.) 1st LL, A.U.S. 

Keislar, H. D., Iowa City (Washington, D. C.) 1st Lt., A.U.S. 

Lage, R. H., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. U.S.N.R. 

Laubscher, J. H., Iowa City (Ft. Benning, Ga.) . . . .1st Lt., A.U.S. 

Longwell, F. H., Iowa City (APO 515, New York, 

N, Y.) Major, A.U.S. 

Moreland. F. B., Iowa City (Maxwell Field, Ala.) . . 1st Lt., A.U.S. 

Nagyfy, S. F., Iowa City (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Newman, R. W., Iowa City (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Parkin, G, L., Iowa City (Mountain Home, Idaho) 1st Lt., A.U,S. 

Paulus, E. W., Iowa City (APO 34, New York, 

N, Y.) Lt. Col., A.U.S. 

Petersen, V, W,, Iowa City (APO 689, New York, 

N, Y.) Col., A.U.S. 

Sells, R. L., Jr., Iowa City (Palmdale, Cal.) Capt., A.U.S. 

Smith, H. F., Iowa City (New York. N. Y.) Lt. Comdr., U.S.N.R. 

Springer, E, W-. Iowa City (APO 622, Miami, Fla,) 1st Lt., A.U.S. 

Stadler, H. E., Iowa City (Washington, D. C. )... .1st Lt., A.U.S. 

Staggs. W. A., Iowa City (Camp Robinson, Ark.) . .Major, A.U.S. 

Stephens. R. L.. Iowa City (Orlando. Fla.) Capt., A.U.S. 

Stump, R. B., Iowa City (Denver, Colo.) Capt.. A.U.S. 


Titus, E. L., Iowa City (Belmont, Mass.) Col., A.U.S. 

Trapasso, T. J., Iowa City (Patterson Field, Ohio) . 1st Lt., A.U.S. 
Trussell, R. E., Iowa City (APO 5467, San Francisco. 

Cal.) Capt., A.U.S. 

Vest, W. M., Iowa City (Fort Missoula, Mont.) Capt., A.U.S. 

Ward, R. H., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Weatherly, H. E., Iowa City (APO 72, San Francisco, 

Cal.) Capt., A.U.S. 

Wollmann, W. W., Iowa City (Staunton, Va.) 1st Lt., A.U.S. 

Ziffren, S. E., Iowa City (Springfield. Mo.) 1st Lt., A.U.S. 

Junior members 

Adams, M. P., Iowa City Lt. (jg), U.S.N.R. 

Ahrens, J. H., Iowa City (APO San Francisco, Cal.) ... .A.U.S. 

Ball, A. L., Iowa City (Camp Polk, La.) Major, A.U.S. 

Barrant, M. E., Iowa City (Camp Tyson, Tenn.) . .Capt., A.U.S. 
Black, N. M., Iowa City (McChord Field. Wash.) 1st Lt., A.U.S. 
Blair, J. D„ Iowa City (APO San Francisco, Cal.) .Major, A.U.S. 

Boyd, R. J.. Iowa City (Spokane. Wash.) Capt., A.U.S. 

Brintnall, E. S., Iowa City (Colorado Springs, 

Colo.) 1st Lt., A.U.S. 

Burr, S. P., Iowa City (APO San Francisco, Cal.) . 1st Lt., A.U.S. 

Carney, R. G., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R 

Connole, J. F., Iowa City (Camp Bowie, Texas) .. 1st Lt., A.U.S. 
Couch, O. A., Iowa City (Camp Van Dorn, Miss.) .. 1st LL, A.U.S. 
Decker, C. E., Iowa City (Oklahoma City, Okla.) . .1st Lt,, A,U.S. 
Donnelly, B. A., Iowa City (APO San Francisco, 

Cal.) 1st Lt., A.U.S 

Ehrehhaft, J. L., Iowa City (APO New York, 

N. Y.) 1st LL, A.U.S. 

Englerth, F. L., Iowa City (APO San Francisco, 

Cal.) Capt., A.U.S. 

Freiberg, M., Iowa City (Jefferson Barracks, Mo.) A.U.S. 

Glassman, A. L., Iowa City (Palm Springs, Cal.) 1st Lt., A.U.S. 
Gilliland, C. H., Iowa City (Great Lakes, 111.) LL (jg). U.S.N.R 

Hamilton, H. E., Iowa City (Chicago, 111.) 1st LL, A.U.S. 

Harms. G. E., Iowa City (Carlisle Barracks, 

Penn.) 1st LL, A.U.S. 

Hendricks, A. B., Iowa City (Klamath Falls, Ore.) , . ,Lt., U.S.N. 
Hovis, Wm., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. (jg), U.S.N.R. 

Ide, L. W., Iowa City (Fort Warren, Wyo.) 1st Lt., A.U.S. 

Jacobs, C. A., Iowa City (APO New York, N. Y,) Major, A.U.S. 
Kaplan, Nathan, Iowa City (Carlisle Bar- 
racks, Pa.) 1st LL, A.U.S. 

Keil, P. G., Iowa City (Sioux City. Iowa) 1st LL, A.U.S. 

Kelberg, M. R., Iowa City (Alameda, Cal.) LL, U.S.N.R. 

Keleher, M. F., Iowa City (Great Lakes, Ill.)..Lt, (jg), U.S.N.R. 

Keohen, G. F., Iowa City (Camp Grant, 111.) Capt., A.U.S. 

Kugler, F. K, Iowa City (Fort Warren, Wyo.) Capt., A.U.S. 

Lowry, F. C„ Iowa City (Sioux Falls, S. D.) 1st LL, A.U.S. 

McCann, J. P., Iowa City (Carlisle Barracks, 

Penn.) 1st LL, A.U.S. 

McQuiston, W. O., Iowa City (APO San Francisco, 

Cal.) Capt., A.U.S. 

Moen, B. H., Iowa City 

Moon, R. E„ Iowa City (APO New York, N. Y.) .. 1st LL, A.U.S. 

Odell, Lester, Iowa City (Pensacola, Fla.) Lt. O'k). U.S.N.R. 

Phillips. R. M., Iowa City (San Francisco, Cal.) . ,1st LL, A.U.S. 
Pulliam, R. L., Iowa City (APO 350, New York, 

N. Y.) Major,A.U.S. 

Randall, C. G., Iowa City 

Randall, R. G., Iowa City (Waterloo, Iowa) CapL, A.U.S. 

Rosenbusch, M., Iowa City (Fort Leonard Wood, 

Mo.) IstLL, A.U.S. 

Russin, L. A., Iowa City (Fort Blanding, Fla.) Capt., A.U.S. 

Saar, J. L., Iowa City (APO New York, N. Y.) .. .CapL, A.U.S. 

Sawtelle, W. W., Iowa City LL, U.S.N.R. 

Schwidde, J. T., Iowa City (Carlisle Barracks, 

Penn.) 1st LL, A.U.S. 

Shand, J. A., Iowa City (Carlisle Barracks, 

Penn.) IstLL, A.U.S. 

Shapiro, S. I., Iowa City 

Simpson, F. E„ Iowa City (Camp Grant. III.) A.U.S. 

Skewis, J. E., Iowa City (Corona, Cal.) LL, U.S.N.R. 

Skouge, O. T., Iowa City 

Towle, R. A,, Iowa City (Fleet PO, San Francisco, 

Cal.) LL, U.S.N.R 

Warren, R. F., Iowa City (Santa Barbara, Cal.) A.U.S. 

Watters, V. G., Iowa City (Fort Leonard Wood, 

„ Mo.) 1st LL, A.U.S. 

Wicks, W. J., Iowa City (Camp Crowder, Mo.) CapL, A.U.S. 

Williams. L. A.. Iowa City (Treasure Island, Cal.) .1st LL, A.U.S. 

Willumsen, H. C., Iowa City (Denver, Colo.) CapL, A.U.S. 

Wolkin, J., Iowa City (San Antonio, Texas) CapL, A.U.S. 

Yetter, W. L., Iowa City (APO New York, N. Y.)..CapL, A.U.S. 

Zahrt, N. E., Iowa City (Keesler Field. Miss.) CapL, A.U.S. 

Zimmerman, H. A.. Iowa City (Santa Ana, Cal.) . .1st LL. A.U.S. 
Keokuk County 

Bjork, Floyd, Keota (APO 254, New York, N. Y.) . .CapL, A.U.S. 

Doyle. J. L.. Sigourney (Camp Berkeley, Texas) A.U.S. 

Engelmann, A. T.. What Cheer (Camp Polk, La.) . -CapL, A.U.S. 

Graham, J. A., Gibson (Needles, Cal.) 1st LL, A.U.S. 

Montgomery, (3. E., Keota (Antioch, Cal.) CapL, A.U.S. 

Wiley, Dudley, Hedrick (Mason City, Wash.) 

Kossuth County 

Clapsaddle, D. W., Burt (Denver, Colo.) CapL, A.U.S. 

Corbin, R. L., Luverne (Des Moines, Iowa) CapL, A.U.S. 

Kenefick, J. N., Algona (San Diego, Cal.)..I>t. Comdr., U.S.N.R 
Williams, R. L., Lakota (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 


24 


Journal ou Iowa State Medical Society 


January, 1945 


Ijce County 

Ashline. G. H., Keokuk (APO 253, New York, N. Y.) Capt., A.U.S. 
Cleary, H. G., Fort Madison (Ft. Bennine, Ga.) 

Capt., A.U,S. 

Cooper, R. E., Keokuk (APO B65. San Francisco, Cal.) Capt. A.U.S. 
.Johnstone, A. A., Keokuk (APO 942, Seattle, Wash.) .Col., A.U.S 

McKee, T. L., Keokuk (Miami Beach, Fla.) Major, A.U.S. 

Pumphrey, L. C., Keokuk (Ft. Leonard Wood, Mo.). Major. A.U.S. 

Rankin, J. R.. Keokuk (Memphis, Tenn.) Lt., U.S.N.R. 

Richmond, A. C., Fort Madison (Treasure Island, 

Cal.) Lt. Comdr., U.S.N.R. 

Steffey, F. L., Keokuk (Fort Snelling, Minn.) 

Van Werden, B. D., Keokuk (APO 4777, New York, 

N. Y.) Capt., A.U.S. 

Younan, Thomas, Ft. Madison (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Linn County 

Andre, G. R., Lisbon (APO 90, Ft. Dix, N. J.) ... .Major, A.U.S. 
Berney, P. W., Cedar Rapids (APO 207, New York, N. 

Y.) Capt., A.U.S. 

Block, W. M., Cedar Rapids (APO 713, San Francisco, 

Cal.) Capt., A.U.S. 

Chapman, R. M., Cedar Rapids (Chicago, 111.) Capt., A.U.S. 

Coughlan, V. H., Coggon (Fort Snelling, Minn.) A.U.S. 

Counter, W. O., Springville (APO 464, New York, 

N. Y.) Major, A.U.S. 

Downing. J. S„ Cedar Rapids (APO B65, San Francisco, 

Cal.) Major, A.U.S. 

Dunn, F. C.. Cedar Rapids (Winfield, Kan.) . .Major, A.U.S. 

Gearhart, Merriam, Springville (Phoenixville, Pa.) . .Major, A.U.S. 
Gerstman, Herbert, Marion (Camp Van Dorn, Miss.) Capt., A.U.S. 
Halpin, L. J., Cedar Rapids (APO 17928, San Francisco, 

Cal Major, A.U.S. 

Hecker, J. T., Cedar Rapids (Camp Bowie, Texas) .. Capt., A.U.S. 
Jirsa, H. O., Cedar Rapids (APO 871, New York, 

N. Y.) Lt. Col., A.U.S. 

Keith, J. J., Marion (Menlo Park, Cal.) Major, A.U.S. 

Kieck, E. G., Cedar Rapids (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Kruckenberg, W. G., Mount Vernon (Fleet PO, San 

Francisco, Cal.) Lt., U.S.N.R. 

Leedham, C. L., Springville (APO 465, New York, 

N. Y.) Col., A.U.S. 

Locher, R. C., Cedar Rapids (Camp Gruber, Okla.) .Major, A.U.S. 
tMacDougal, R. F., Cedar Rapids (APO 9057, New York, 

N. Y.) Capt., A.U.S. 

McConkie, E. B., Cedar Rapids (Scott Field. 111.) .. Major, A.U.S. 
McQuiston, J. S., Cedar Rapids (Fort Warren, 

Wyo.) Major, A.U.S. 

Meffert, C. B., Cedar Rapids (APO 403, New York, 

N. Y.) Lt. Col., A.U.S. 

Murray, E. S„ Cedar Rapids (APO 787, New York, 

N. Y.) Major, A.U.S. 

Netolicky, R. Y.. Cedar Rapids (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Noble, W. C., Cedar Rapids (Camp San Luis Obispo. 

Cal.) 1st Lt., A.U.S. 

Noe, C. A., Cedar Rapids (Hot Springs, Ark.) ... .Major, A.U.S. 
Parke. John, Cedar Rapids (APO 761, New York, 

N. Y.) Major, A.U.S. 

Proctor, R. D.. Cedar Rapids (Corpus Christi, 

Texas) Comdr., U.S.N.R. 

Redmond, J. J., Cedar Rapids (APO 813, New York, 

„.N. Y.) Major. A.U.S. 

Rieniets, J. H., Cedar Rapids (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr.,U.S.N.R. 

Sedlacek, L. B., Cedar Rapids (APO 244, San Francisco, 

„ Cal.) Lt. Col., A.U.S. 

Smrha, J. A., Cedar Rapids (APO 922, San Fran- 
cisco. Cal.) .Capt., A.U.S. 

Stansbury, J. R., Cedar Rapids (Fort Lewis, 

Wash.) Capt., A.U.S. 

Stark, C. H., Cedar Rapids (Denver, Colo.) Capt., A.U.S. 

Sulek, A. E., Cedar Rapids (APO 244, San Fran- 
cisco, Cal.) Major, A.U.S. 

Woodhouse, K. W.. Cedar Rapids (APO 519, New York, 

,• Lt. Col., A.U.S. 

Wray, R. M., Cedar Rapids (APO 958, San Francisco, 

„Cal.) Major, A.U.S. 

Yavorsky, W. D., Cedar Rapids (Jacksonville, Fla.) 

Lt. Comdr., U.S.N. 

Louisa County 

DeYarman, K. T., Morning Sun (San Antonio. 

Texas) Capt., A.U.S. 

Tandy, R. W., Morning Sun (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Lucas County 

Lister, K. E., Chariton (Fort Snelling, Minn.) A.U.S. 

Lyon County 

Cook, S. H., Rock Rapids (Memphis, Tenn.) Major, A.U.S. 

tCorcoran, T. E., Rock Rapids (Am. P.O.W. 3040, Oflag 64, 

Germany) Capt., A.U.S. 

Moriarty, J. F., Rock Rapids (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Madison County 
Boden, H. N., Truro (Fresno, Cal.) 

Chesnut, P. F., Winterset (Camp Gruber, Okla.) . . . .Capt., A.U.S. 
Veltman, J. F.. Winterset (APO 957, San Francisco, 

Cal.) Capt., A.U.S. 

Wicks. R. L., Winterset (APO 637, New York, N. Y.) 

Lt. Col., A.U.S. 


Mahaska County 

Bennett, G. W., Oskaloosa (APO 9641, San Francisco, 

Cal.) Major. A.U.S. 

Bos, H. C.. Oskaloosa Major. A.U.S. 

Campbell, W. V., Oskaloosa (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Clark. G. H., Oskaloosa (Mare Island, Cal.) . .Lt. Comdr., U.S.N.R. 

Greenlee. M. R., Oskaloosa (Port Hueneme, 

Cal.) Lt. Comdr., U. S.N.R. 

Lemon, K. M., Oskaloosa (APO 637, New York, 

N. Y.) Capt., A.U.S. 

Zager, L. L., Oskaloosa (APO 436, New York, 

N. Y.) Capt., A.U.S. 

Marion County 

Elliott, V. J., Knoxville (APO 558, New York, 

N. Y.) Major, A.U.S. 

Mater, D. A., Knoxville (Lincoln, Neb.) Major, A.U.S. 

Ralston, F. P., Knoxville (Indio, Cal.) Capt., A.U.S. 

Schiek, C. M., Knoxville Lt. Comdr., U.S.N.R. 

Schroeder, M. C., Pella (Houston, Texas) Capt., A.U.S. 

Williams, D. B., Knoxville Capt., A.U.S. 

Marshall County 

Carpenter, R. C., Marshalltown (APO 678 New York, 

N. Y.) Capt., A.U.S. 

Marble, E. J., Marshalltown (Fleet PO, Can Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Marble, W. P., Marshalltown (Colorado Springs, 

Colo.) Major, A.U.S. 

Meyer, M. G., Marshalltown (APO 513, New York, 

N. Y.) Major, A.U.S. 

Noonan, J. J., Marshalltown (Fort Jackson, 

S. Car.) LL Col., A.U.S. 

Phelps, R. E., State Center (APO 7, San Francisco, 

Cal.) Capt., A.U.S. 

Sinning, J E., Melbourne (Camp Haan, Cal.) Capt., A.U.S. 

Smith, E. M., State Center (APO 520, New York, 

N. Y.) Lt, Col., A.U.S. 

Stegman, J. J., Marshalltown (APO 620, New York, 

N. Y’.) Major, A.U.S. 

Wells, R. C., Marshalltown (Gowen Field, Idaho) . . . .Capt., A.U.S, 

Wolfe, O. D., Marshalltown (APO 937, Seattle 
Wash.) Capt., A.U.S. 

Wolfe, R. M., Marshalltown (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Mills County 

DeYoung, W. A., Glenwood (APO 228, New York, 

N. Y.) Capt., A.U.S. 

Magaret, E. C., Glenwood (APO 973, Minneapolis, 

Minn.) Capt., A.U.S. 

Shonka, T. E., Malvern (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Mitchell County 

Culbertson, R. A., St. Ansgar (APO 17928, San 

Francisco, Cal.) Lt. Col., A.U.S. 

Moore, E. E., Osage (APO 591, New York, N. Y.) . Major, A.U.S. 

Owen, W. E., Osage (Fleet PO, San Francisco, Cal.) 

Lt. (jg), U.S.N.R. 

Walker, T. G., Riceville (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Monona County 

Aimer, L. E., Moorhead (Fort Knox, Ky.) Capt., A.U.S. 

Anderson, S. N., Onawa (Great Lakes, 111.) .Lt., U.S.N.R. 

Ganzhorn, H. L., Mapleton (APO 928, San Francisco, 

Cal.) Capt., A.U.S. 

Gaukel, L. A., Onawa (Fort Riley, Kan.) Capt., A.U.S. 

tHarlan, M. E., Onawa (Fleet PO, San Francisco, 

Cal.) Lt. (jg), U.S.N.R. 

Stauch, M. O., Whiting (Fort Lewis, Wash.) Major. A.U.S. 

Wainwright, M. T., Mapleton (APO 17508, New York, 

N. Y.) Capt., A.U.S. 

Wolpert, P. L., Onawa (Denver, Colo.) Capt., A.U.S. 

Monroe County 

Gilliland. C. H., Albia (Quonset Point, R. I.) Lt., U.S.N.R. 

Heimann, V. R., Albia (Camp Maxey, Texas) Capt., A.U.S. 

Richter, H. J., Albia (Waco, Texas) Major, A.U.S. 

Smith, R. A., Albia (New Cumberland, Pa.) Capt., A.U.S. 

Montgomery County 

Bastron, H. C., Red Oak (APO 951, San Francisco, 

Cal.) Major, A.U.S. 

Hansen, F. A., Red Oak (Fleet PO, San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

Nelson, C. C., Red Oak (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Panzer, E. J. C!., Stanton (Fleet PO, San Francisco, 

Cal.) Lt. (jg). U.S.N.R. 

Rost, G. S., Red Oak (Chickasha, Okla.) Capt., A.U.S. 

Sorensen, E. M., Red Oak (Jefferson Barracks, 

Mo.) Capt., A.U.S. 

Muscatine County 

Ady, A. E., West Liberty (Pensacola, Fla.) Comdr., U.S.N.R. 

Asthalter, R. W., Muscatine (Fort Meade, Md.) .. .1st Lt.. A.U.S. 

Carlson, E. H., Muscatine (Milwaukee, Wis.) Capt., A.U.S. 

Goad, R. R., Muscatine (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

Kimball, J. E., Jr., West Liberty (Sioux City, Iowa) .Major, A.U.S. 

Lindley, E. L., Muscatine (APO 6, San Francisco, 

Cal.) Capt., A.U.S. 

Muhs, E. O., Muscatine (APO 578, New York, 

N. Y.) Major, A.U.S. 

Norem, Walter, Muscatine (APO, Miami, Fla.) Capt., A.U.S. 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


25 


Robertson. T. A., West Liberty (APO 119, New York, 

N. y.) Capt., A.U.S. 

Sywassink, G. A., Muscatine (APO 488-‘‘Y” 

Forces, New York, N. Y.) Lt. Col., A.U.S. 

Whitmer, L. H., Wilton Junction (Fort Sill, 

Okla.) Lt. Col., A.U.S. 

O’Brien County 

Getty, E. B., Primghar (APO 176, New York, 

N. Y.) Capt., A.U.S. 

Hayne, W. W., Paullina (APO 638, New York, 

N. Y.) Capt., A.U.S. 

Moen, S. T., Hartley (APO 689, New York, 

N. Y.) Major, A.U.S. 

Myers. K. W., Sheldon (Watertown, S. Dak.) 1st Lt., A.U.S. 

Osceola County 

KunU, G. S„ Sibley (APO 34. New York. N. Y.) . . . .Capt., A.U.S. 

Page County 

Barnes, C. A., Shenandoah (Fort Bragg, N. C.) ... .Capt., A.U.S. 

Blackman, Nathan, Clarinda (Ft. Leavenworth, 

Kan.) Capt., A.U.S. 

Bossingham. E. N„ Clarinda (Fort Ord, Cal.) Major, A.U.S. 

Bunch, H. McK., Shenandoah (San Diego, 

Cal.) Lt. Comdr., U.S.N.R 

Burdick, F. D., Shenandoah Capt., A.U.S. 

Burnett. F. K., Clarinda (Denver, Colo.) Major, A.U.S. 

Rausch, G. R., Clarinda (Sioux City, Iowa) Capt., A.U.S. 

Savage, L. W., Shenandoah (Fort Meade, Md.) .... 1st Lt., A.U.S. 

Palo Alto County 

Davey, W. P., Emmetsburg (Fleet PO, San 

Francisco, Cal.) Lt.. U.S.N.R. 

Plymouth County 

Bowers. C. V., LeMars (APO New York, N. Y.) . .1st Lt., A.U.S. 

Fisch, R. J., LeMars (Denver, Colo.) Capt., A.U.S. 

Foes, R. H„ Remsen (Salt Lake City, Utah) Capt., A.U.S. 

Wolfson, Harold. Kingsley (Fort Lewis. Wash.) Capt., A.U.S. 

Pocahontas County 

Blair. F. L., Jr., Fonda (San Antonio, Texas) Lt., U.S.N.R. 

Herrick, T. G., Gilmore City (APO 9876, New York, 

N. Y.) Capt., A.U.S. 

Larson, J. B., Laurens (APO 720, San Francisco, 

Cal.) Capt., A.U.S. 

Leserman, L. K.. Rolfe (APO 502, San PVancisco, 

Cal.) Capt., A.U.S. 

Patterson, A. W„ Fonda (Des Moines. Iowa) Capt., A.U.S. 

Polk County 

Abbott, W. D., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Anderson, N. B., Des Moines (APO 667, New York, 

N. Y.) Lt. Col., A.U.S 

Angell, C. A., Des Moines (FT. Bragg, N. Car.) ... .Capt., A.U.S. 

Anspach, R. S., Mitchellville (APO 528, New York, 

N. Y.) Lt. Col., A.U.S. 

Earner, J. L., Des Moines (Atlanta, Ga.) Major, A.U.S. 

Barnes, B. C., Des Moines (Ogden, Utah) Major, A.U.S. 

Bates. M. T., Des Moines (Corona, Cal.) .... Lt. Comdr., U.S.N.R. 

Bender, H. R., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Bond, T. A., Des Moines (Shoemaker, Cal.) Lt., U.S.N.R. 

Bone, H. C., Des Moines (Arlington, Cal.) Major, A.U.S. 

Brown, A. W., Des Moines (APO 6934, New York, 

N. Y.) Capt., A.U.S. 

Bruner, J. M., Des Moines (Camp Berkeley, Texas) . .Major, A.U.S. 

Bruns, P. D., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

JBurgeson, F. M., Des Moines (Gefangenennummer 1480, 
Lager-Bezeichnung : Kriegsgef-Offizierlager XXI B, 
Deutschland [Allemagne]) Capt., A.U.S. 

Caldwell, J. W., Des Moines, (Patricia Bay, 

British Columbia, Canada) Flight Lt., R.C.A.F. 

Chambers, J. W.. Des Moines (APO 648, New York, 

N. Y.) Capt., A.U.S. 

Chase, W. B., Jr., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt.. U.S.N.R. 

Clark, G. E., Jr.. Des Moines (APO 520, New York, 

N. Y.) Capt., A.U.S. 

Connell, J. R.. Des Moines (Phoenixville, Pa.) Major, A.U.S. 

Corn, H. H., Des Moines (Douglas, Wyo.) Capt., A.U.S. 

Coughlan, D. W., Des Moines (APO 689, New York, 

N. Y.) ■! Capt.. A.U.S. 

Crowley, D. F., Jr., Des Moines (Presque Isle, Me.) . .Capt., A.U.S. 

Crowley, F. A.. Des Moines (APO 783, New York, 

N. Y.) Capt., A.U.S. 

DeCicco, Ralph. Des Moines (APO 952, San Francisco. 

Cal.) Capt., A.U.S. 

Decker, H. G., Des Moines (Long Beach, 

Cal.) Lt. Comdr., U.S.N.R. 

Downing, A. H., Des Moines (Ft. Snelling, Minn.) . 1st Lt., A.U.S. 

Dushkin, M. A., Des Moines (APO 689, New York, 

N. Y.) Lt. Col., A.U.S. 

Elliott, 0. A., Des Moines (Pecos, Texas) Capt., A.U.S. 

Ellis, H. G., Des Moines (APO 710, San Francisco, 

Cal. ) Capt., A.U.S. 

Ervin, L. J., Des Moines (Lubbock, Texas) Lt. Col., A.U.S. 

Fleck, W. L.. Des Moines (Ft. Howard, Md.) Lt. Col., A.U.S. 

Fried. David, Des Moines (Carlisle Barracks. 

Penn.) 1st Lt.. A.U.S. 

Fracasse, John, Des Moines 1st Lt., A.U.S. 

George, E. M., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Gerchek, E. W., Des Moines 


Gibson, D. N„ Des Moines (APO 322, Unit I, San 
Francisco. Cal.) Major, A.U.S. 

Glomset, D. A., Des Moines (APO 9826 New York, 

N. Y.) Capt.. A.U.S. 

Goldberg, Louie, Des Moines (APO 9764, San Francisco. 

Cal.) Capt., A.U.S. 

Gordon. A. M.. Des Moines (APO 763, New York. 

N. Y.) Capt., A.U.S. 

Graeber, F. O., Des Moines (Fleet PO, San FTancisco, 

Cal.) Lt.. U.S.N.K 

Greek, L. M„ Des Moines (APO 512, New York, 

N. Y.) Capt., A.U.S. 

Gurau, H. H., Des Moines (Malden, Mo.) Capt., A.U.S. 

Haines, D. J., Des Moines (APO 453, San Francisco, 

Cal.) Capt.. A.U.S. 

Harris, D. D., Des Moines (Gulfport, Miss.) . .Lt. Comdr., U.S.N.R, 

Harris. H. L., Des Moines (Salina, Kan.) 1st Lt., A.U.S. 

Hess, John, Jr., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

James, A. D., Des Moines (Fort Eustis, Va.) .. .Comdr., U.S.N.R. 

Johnston, C. H., Des Moines (APO 639, New York, 

N. Y.) Lt. Col., A.U.S. 

Kast, D. H., Des Moines (Los Angeles, Cal.) Capt., A.U.S. 

Kelley, E. J., Des Moines (Columbus, Ohio) . .Lt. Comdr., U.S.N.R. 

Kelly, D H., Des Moines (Denver, Colo.) Lt. Col., A.U.S. 

Kirch, W. A. W., Des Moines (Astoria, Ore.) .Lt. Comdr., U.S.N.R. 

Klocksiem, H. L„ Des Moines (APO New York, 

N. Y.) Capt., A.U.S. 

Kottke, E. E., Des Moines (Temple, Texas) Capt., A.U.S. 

Landis. S. N., Des Moines (West Palm Beach, 

Fla.) 1st Lt.. A.U.S. 

La Tona, Salvatore, Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Lederman, James, Des Moines 1st Lt., R.C.A. 

Lehman, E. W., Des Moines (APO 11115, 

San Francisco. Cal.) Major, A.U.S. 

Losh, C. W., Jr., Des Moines (APO 209, New York, 

N. Y.) 1st Lt., A.U.S. 

Lovejoy, E. P., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Maloney, P. J., Des Moines (Fort Lewis. Wash.) . . .1st Lt., A.U.S. 

Marquis, G. S., Des Moines (Brooklyn, N. Y.) .Lt. Comdr., U.S.N.R. 

Martin, L. E.. Des Moines (Helena, Ark.) 1st Lt., A.U.S. 

Matheson, J. H., Des Moines (San Leandro, 

Cal.) Lt. Comdr., U.S.N.R. 

Mauritz, E. L., Des Moines (APO 763, New York. 

N. Y.) Capt., A.U.S. 

McCoy. H. J., Des MoineS (Iowa City, Iowa) ... Comdr., U.S.N.R. 

McDonald, D. J., Des Moines (APO 339, New York, 

N. Y.) Major, A.U.S. 

McNamee, J. H., Des Moines (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

Mencher, E. W., Des Moines 1st Lt., A.U.S. 

Merkel, B. M., Des Moines (APO 520, New York, 

N. Y.) Major, A.U.S. 

Montgomery, S. A., Des Moines (Carlisle Barracks, 

Pa.) Capt, A.U.S. 

Morden, R. P., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S 

Mumma, C. S., Des Moines (Los .^.ngeles, Cal.) ... .Major, A.U.S. 

Murphy, J. H., Des Moines (Fleet PO, San FYan- 
cisco. Cal.) Lt., U.S.N.R. 

Nelson, A. L., Des Moines (Camp Livingston, La.) Major, A.U.S. 

Noun, L. J., Des Moines (Camp Peary, Va.) Lt., U.S.N.R. 

Noun, M. H., Des Moines (APO 228, New York, 

N. Y.) Major, A.U.S 

Nourse, M. H., Des Moines (Fleet PO, New York, 

N. Y.) Lt., U.S.N. 

Patton, B. W., Des Moines (Camp Robinson, 

Ark.) 1st Lt., A.U.S. 

Pearlman, L. R., Des Moines (Camp Gruber, Okla.) .Major, A.U.S. 

Peisen, C. J., Des Moines (APO 165, New York, 

N. Y.) Capt, A.U.S. 

Penn, E. C., West Des Moines (APO 650, New York, 

N. Y.) Capt, A.U.S. 

Pfeiffer, E. P., Des Moines (APO 11043, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Phillips, A. B., Des Moines (Corona, Cal.) Lt, U.S.N.R. 

Porter, R. J., Des Moines (APO 635, New York, 

N. Y.) Capt, A.U.S. 

Powell. L. D., Des Moines (Oceanside, Cal.) Capt, U.S.N.R. 

Pratt, E. B., Des Moines (APO New York, N. Y.) . .Major, A.U.S. 

Priestley, J. B., Des Moines (Camp Crowder, Mo.) .Lt. Col., A.U.S. 

Purdy. W. 0„ Des Moines (APO 5935, New York, 

N. Y.) Capt, A.U.S. 

Riegelman, R. H., Des Moines (APO 634, New York, 

N. Y.) Major. A.U.S. 

Robinson. V. C., Des Moines (Gulfport, Miss.) Major, A.U.S. 

Rotkow, M, J., Des Moines (Ft. Benj. Harrison, 

Ind.) Capt, A.U.S. 

Schaeferle, M. J., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt, A.U.S. 

Schlaser, V. L., Des Moines (Fleet PO, San Francsico, 

Cal.) Lt, U.S.N. 

Shepherd, L. K., Des Moines (APO New York, 

N. Y.) Major, A.U.S. 

Shiftier. H. K., Des Moines (APO 230, New York, 

N. Y.) Capt, A.U.S. 

Singer, P. L., Des Moines (Camp Grant, 111.) ... .1st Lt, A.U.S. 

Skultety, J. A., Des Moines (New Orleans. La.) 

P. A. Surg., U.S.P.H.S. 

Smead. H. H., Des Moines (APO 695, New York, 

N. Y.) Capt, A.U.S. 


26 


JouRNAr. OF Iowa State Medical Society 


January. 1945 


Smith. H. Des Moi'.tes (Chicago, 111.) Lt.. U.S.N.R. 

Smith. 11. T.. De.s Moines (APO 713, Unit I, San Francisco, 

Cal. I Capt.. A.U.S. 

"Snodirrass. R. W.. Des Moines (APO 9528, New York. 

N. Y. I Capt.. A.U.S 

Snytler. G. E.. Grimes (APO 261, San Francisco, 

(Ilal.) Major. .A. IT.. S. 

Sohm. H. A., Des Moines Lt. Comdr., U.S.N.R. 

Sorensen. R. M., Des Moines (Topeka. Kan. I . . Major, U.S.P.H.S. 

Sprinsrer, F. A.. Des Moines (Treasure Island. 

Cal.) Lt. Comdr., U.S.N.R. 

Stearns, A. B.. Des Moines (Denver. Colo.) Major, A.U.S. 

Stickler. Robert, Des Moines (Fort Bennins, Ga. ).. Capt.. A.U.S. 

Stitt, P. L.. Des Moine.s (Seattle. Wash.) Lt. (jp: I , U.S.N.R. 

Throckmorton. J. F.. Des Moines (APO 339, New York, 

N. Y. ) Major, A.U.S. 

Touhe'. A. A., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Turner, H. V., Des Moines (Camp Fannin. Texas) . . .Capt., A.U.S. 

Updeftraff, Thomas. Des Moines (Spokane, Wash.) . 1st Lt., A.U.S. 

Van Hale, L. A., Des Moines (APO 515, New York, 

N. Y.) Capt., A.U.S. 

Vaubel, E. K., Des Moines (Washington, D. C.) .... Capt., A.U.S. 

Wagner, E. C., Des Moines (Washington, D. C.) .. 1st Lt., A.U.S. 

Willett, W. M., Des Moines (APO 507, New York, 

N. Y.) Capt., A.U.S. 

Wirtz, D. C., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Zarchy, A. C.. Des Moines (Camp Cooke. Cal.) ,... Capt., A.U.S. 

I*ottasr:ittumie County 

JBeaumont, F. H., Council Bluffs (APO 34. New York, 

N. Y.) Major, A.U.S. 

Collins. R. M., Council Bluffs (Fleet PO, San Francisco, 

Cal.) Lt.. U.S.N.R. 

Dean. A. M„ Council Bluffs (Pensacola. Fla.) .. .Comdr., U.S.N.R. 

Edwards, C. V., Council Bluffs (Pensacola, Fla.) 

Lt. Comdr., U.S.N.R. 

Floersch. E. B., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Hennessy, J. D., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Jensen, A. L.. Council Bluffs (Temple, Texas) ... .Lt. Col., A.U.S. 

Klok, G. J.. Council Bluffs (Fleet PO. San Diego, 

,Cal.) Lt., U.S.N.R. 

Kurth, C. J., Council Bluffs (Camp Crowder, Mo.) .. Capt., A.U.S. 

Limbert, E. M., Council Bluffs (APO 403, New York, 

N. Y.) ..Major, A.U.S. 

Maiden, S. D., Council Bluffs (Camp Hood, Texas) . .Major, A.U.S. 

Martin. L. R.. Council Bluffs (San Francisco. Cal.) .. Capt., A.U.S. 

Mathiasen, H. W., Neola (Alexandria. La.) Capt., A.U.S. 

Moskovitz, J. M., Council Bluffs (APO 403, New York, 

„N. Y.) Capt., A.U.S. 

Rosenfeld, R. T.. Council Bluffs (Staten Island, 

N. Y.) Capt., A.U.S. 

Standeven. W.. Oakland (Colorado Springs, Colo.) . .Capt., A.U.S. 

Sternhill. Isaac, Council Bluffs (Springfield, Mo.) .. .Capt., A.U.S. 

Tinley, R. E„ Council Bluffs (APO 600, New York, 

N- Y.) Major, A.U.S. 

Treynor, J. V., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Comdr., U.S.N.R. 

West, A. G„ Council Bluffs (APO 230, New York, 

Capt., A.U.S. 

Wieseler, R. J., Avoca (McChord Field, Wash.) AU S 

Wurl, O. A., Council Bluffs (APO 887, New York, 

N. Y.) Major, A.U.S. 

Poweshiek County 

Brobyn, T. E., Grinnell (Camp Swift, Texas) Major, A.U.S. 

Hickerson, L. C., Brooklyn (APO 559, New York, 

Y.) Capt., A.U.S. 

Korfmacher, E. S., Grinnell (APO 92, San Francisco, 

••••••• Capt., A.U.S. 

Niemann, T. V., Brooklyn (APO 43, San Francisco, 

^Cal.) Capt.. A.U.S. 

Parish, J. R., Grinnell (Fleet PO, San Francisco, 

^ Cal.) Lt. Comdr., U.S.N.R. 

Somers, P. E., Grinnell (St. Louis, Mo.) 1st Lt., A.U.S. 

Rin^irold County 

Seaman, C. L., Mount Ayr (Fort Smith, Ark.) ... .Major, A.U.S. 

Sac County 

Bassett, G. H., Sac City (San Diego, Cal.) . .Lt. Comdr., U.S.N.R. 

Deters, D. C., Schaller (APO 34, New York, N. Y Capt., A.U.S. 

Evans, W. I., Sac City (APO 9212, New York, 

N. Y.) Capt., A.U.S. 

Klocksiem, R. G., Odebolt (Oceanside, Cal.) Lt., U.S.N.R. 

Neu, H. N., Sac City (APO 708, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Scott County 

Baker. R. W., Davenport (APO 511, New York, 

N. Y.) Capt., A.U.S. 

Balzer. W. J., Davenport (APO 17665, New York, 

N. Y.) Capt., A.U.S. 

Bishop. J. F., Davenport (Camp Wheeler, Ga.) .... Capt., A.U.S. 

Block, L. A., Davenport (Cambridge, Ohio) Major, A.U.S. 

Boden, W. C., Davenport (APO 3760, New York, 

N. Y.) Capt., A.U.S. 

Boyer, U. S., Davenport (Rock Island. 111.) Lt. Col., A.U.S. 

Brown, M. J., Davenport (APO 5934, New York, 

N. Y.) Major, A.U.S. 

Carey, E. T., Davenport (APO 928, San Francisco, 

Cal.) 1st Lt.. A.U.S. 


Christiansen. C. C.. Dixon (APO 961, San Fran- 
cisco. Cal. I Capt., A.U.S. 

Coleman, Tom, Davenport (APO 230, New York, 

N. Y. I Capt., A.U.S. 

Cummins, G. M., Jr., Davenport (Fort Custer, 

Mich.) Capt., A.U.S. 

Decker. C. E.. Daveniiort (APO 321, San Francisco, 

Cal.) Major, A.U.S. 

Evans. H. J., Davenport (Daytona Beach, Fla.) ... .Capt., A.U.S. 

Gibson, P. E., Davenport (Palm Springs, Cal. ).... Major, A.U.S. 

Goenne, Wm., Jr., Davenport (APO 91, New York, 

N. Y.) Capt., A.U.S. 

Hurevitz, H. M.. Davenport (APO 370, New York, 

N. Y.) Major, A.U.S. 

Hurteau. Everett, Davenport (APO 647, New York, 

N. Y.) Capt., A.U.S. 

Hurteau, W. W., Davenport (Camp Barkeley. 

Texas) Major, A.U.S. 

Kimberly. L. W., Davenport (Hines, 111.) Capt.. A.U.S. 

Krakauer, Max, Davenport (APO 17366, New York, 

N. Y.) Capt., A.U.S. 

Kuhl, A. B., Jr., Davenport (Ft. Meade, Md.) 1st Lt., A.U.S. 

LaDage, L. H., Davenport (APO 229, New York, 

N. Y.) Major, A.U.S. 

Lorfeld, G. W.. Davenport (Columbus. Ohio) Capt., A.U.S. 

Marker, J. L., Davenport (Auburn, Cal.) Col., M.R.C. 

McMeans, T. W., Davenport (APO 557, New York, 

N. Y.) Capt., A.U.S. 

Neufeld, R. J., Davenport (APO 565, Unit I, San Francisco, 

Cal.) Capt., A.U.S. 

Perkins, R. M., Davenport (Carlisle Barracks, 

Pa.) 1st Lt., A.U.S. 

Sheeler, I. H., Davenport (APO 350, New York, 

N. Y.) Capt., A.U.S. 

Shorey, J. R., Davenport (APO 204, New York, 

N. Y.) Capt., A.U.S. 

Smazal, S. F., Davenport (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Sorenson, A. C., Davenport (Oakland, Cal.) ... Comdr., U.S.N.R. 

Sunderbruch, J. H., Davenport (APO 322, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Weinberg, H. B., Davenport (APO 5587, San Francisco, 

Cal.) Major, A.U.S. 

Zukerman, C. M., Bettendorf (Chicago, III.) Capt., A.U.S. 

Shelliy County 

Bisgard, C. V., Harlan (Farragut, Idaho) .. .Lt. Comdr., U.S.N.R. 

Griffith, W. O., Shelby (APO 9490, New York, 

N Y.) Capt., A.U.S. 

McGowan, J. P., Harlan (Fleet PO. San Francisco. 

Cal.) Lt. Comdr.. U.S.N.R. 

Sioux County 

Gleysteen, R. R., Alton (Portsmouth. Va.)....Lt. Comdr., U.S.N. 

Grossmann, E. B., Orange City (APO 572, New York, 

N. Y.) Capt., A.U.S. 

Larson, M. O., Hawarden (APO 562, New York, 

N. Y.) Lt. Col.. A.U.S. 

Oelrich, A. M., Hull (APO New York, N. Y.) 1st Lt., A.U.S. 

Oelrich, C. D., Sioux Center (Buckley Field. Colo.). 1st Lt., A.U.S. 

Story County 

Conner, J. D., Nevada (APO 708, San Francisco, 

Cal.) Capt., A.U.S. 

Fellows, J. G., Ames (APO 451, New York. N. Y.) . .Major, A.U.S. 

Lekwa, A. H., Story City (San Diego, Cal.) . .Lt. Comdr., U.S.N.R. 

McFarland, (j. E., Jr., Ames (San Pedro, Cal.) .. .Lt., U.S.N.R. 

McFarland, J. E., Ames (Seattle, Wash.) . . . .Lt. Comdr., U.S.N.R. 

Rosebrook, L. E., Ames (APO 433, New York 

N. Y.) Major, A.U.S. 

Sperow, W. B., (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Thorbum, O. L., Ames (Alamagordo, N. Mex.) .Major, A.U.S. 

Wall, David, Ames (Ft. Dix, N. J.) 1st Lt., A.U.S. 

Tniiia County 

Bezman, H. S., Traer (APO 9875. New York, N. Y.) Capt., A.U.S. 

Boiler, (5. C., Traer (Ft. Riley, Kansas) Capt., A.U.S. 

Dobias, S. G., Chelsea (San Francisco, Cal.) Capt., A.U.S. 

Havlik, A. J., Tama (San Diego, Cal.) Lt.. U.S.N.R. 

Schaeferle, L. G., Gladbrook (Fort Leonard Wood. Mo.) 

Standefer, J. M., Tama (Des Moines, Iowa) Lt., U.S.N.R. 

Taylor County 

Hardin, J. F„ Bedford (APO 952, San Francisco, 

Cal.) 1st Lt., A.U.S. 

Union County 

Beatty, H. G., Creston (New Orleans, La.) 1st Lt., A.U.S. 

Paragas, M. R., Creston (APO 442, San Francisco. 

Cal.) Capt., A.U.S. 

Ryan, C. J., Creston (Scribner, Neb.) Capt., A.U.S. 

Wapello County 

Brentan, Emanuel, Ottumwa (APO 252, New York, 

N. Y.) 1st Lt., A.U.S. 

Brody. Sidney, Ottumwa Lt. Col., A.U.S. 

Gilfillan, C. D. N., Eldon (Battle Creek, Mich.) .... Capt., A.U.S. 

Hughes, R. O., Ottumwa (Coronado, Cal.) . .Lt. Comdr., U.S.N.R. 

Moore, G. C., Ottumwa (APO 17508, New York, 

N. Y.) Capt., A.U.S. 

Nelson, F. L., Jr., Ottumwa Capt., A.U.S. 

Prewitt, L. H., Ottumwa (Atlantic City, N. J.) Major, A.U.S. 

Selman, R. J., Ottumwa (El Paso, Texas) Col., A.U.S. 

Struble, G. C., Ottumwa (Fort Harrison, Ind.) . . . .Lt. Col., A.U.S. 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


27 


Whitehouse, W. N.. Ottumwa (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

Wolfe. W. C., Ottumwa fFleet PO, San Francisco, 

Cal.) Lt. (jg) U.S.N.R. 

Warren County 

Fullgrabe. E. A., Indianola (San Diego, Cal.) Lt., U.S.N.R. 

Hoffman, G. R., Lacona (Camp San Louis Obispo, 

Cal.) Capt., A.U.S. 

Shaw, E. E., Indianola (APO 834, New Orleans, 

La.) Capt., A.U.S. 

Trueblood, C. A., Indianola (APO 871, New York, 

N. Y.) Capt., A.U.S. 

Washinston County 

Boice, C. L., Washington (Fleet PO, New York, 

N. Y.) Lt., U.S.N. 

Droz, A. K., Washington (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

Mast, T. M., Washington (Seattle, Wash.) . . .Lt. Comdr., U.S.N.R. 

Miller. J. R., Wellman (Camp Breckenridge, Ky.).lstLt., A.U.S. 

Stutsman, R. E.. Washington (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Ware. S. C., Kalona (APO 15275. New York, N. Y.).Capt., A.U.S. 

Wayne County 

Hyatt. C. N., Jr., Humeston (APO 6, San Francisco, 

Cal.) Capt., A.U.S. 

W'ebster County 

Baker, C. J., Fort Dodge (APO New York, N. Y.) . .Major, A.U.S. 

Burch. E. S.. Dayton (APO 709. San Francisco, 

Cal.) Capt., A.U.S. 

Burleson, M. W,, Fort Dodge (Pasadena, Cal.) Capt., A.U.S. 

Coughlan, C. H., Fort Dodge (Fort Des Moines, 

Iowa) Major, A.U.S. 

Dawson, E. B., Fort Dodge (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

Glesne, 0. N.. Ft. Dodge (New River, N. C.).Lt. Comdr., U.S.N.R. 

Joyner, N. M., Fort Dodge (Minneapolis, Minn.) A.U.S. 

Kluever, H. C., Fort Dodge (St. Louis, Mo.) 

Lt. Comdr., U.S.N.R. 

Larsen, H. T., Fort Dodge (Pensacola, Fla.) Lt., U.S.N.R. 

Shrader. J. C.. Fort Dodge (APO 758, New York, 

N. Y.) ! Lt. Col., A.U.S. 

•Thatcher, 0. D., Fort Dodge (APO 634, New York, 

N. Y.) Capt., A.U.S. 

Thatcher, W. C., Fort Dodge (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Van Patten, E. M., Ft. Dodge (El Paso, Texas) .... Capt., A.U.S. 

Winneshiek County 

Fritchen, A. F., Decorah (Mare Island, Cal.) . .Comdr., U.S.N.R. 

Hospodarsky, L. J., Ridgeway (APO 638, New York, 

N. Y.) Lt. Col., A.U.S. 

Howard, W. H.. Decorah Capt., A.U.S. 

Larson, L. E., Decorah (Fleet PO, San Francisco, 

Cal. I Lt. Comdr., U.S.N.R. 

Svendsen. R. N., Decorah (San Diego, Cal.)...Lt. (jg), U.S.N.R. 

Van Besien. G. J., Decorah (Springfield. Mo.) ... .Capt., A.U.S. 

Woodbury County 

Bettler, P. L., Sioux City (APO 235, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Blackstone, M. A., Siou,x City (Camp Stoneman, 

Cal.) Capt., A.U.S. 

Boe, Henry, Sioux City (Fort Snelling, Minn.) Capt., A.U.S. 

Burroughs, H. H., Sioux City (Fleet PO, San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

JCmeyla, P. M., Sioux City (P.O.W., c/o Japanese 

Red Cross, Tokyo, Japan) Capt., A.U.S. 

Cowan. J. A., Sioux City (Oklahoma City, 

Okla.) Major. U.S.P.H.S. 

Crowder, R. E., Sioux City (Kansas City, 

Mo.) Lt. Comdr., U.S.N.R. 

Dimsdale. L. J.. Sioux City (Clinton, Iowa) Capt., A.U.S. 

Down, H. I., Sioux City (APO 758, New York, 

N. Y.) Lt. Col., A.U.S. 

Elson, V. J., Danbury (APO 9875, New York, 

N. Y.) Capt., A.U.S. 

Frank, L. J., Sioux City (Vallejo, Cal.) Comdr., U.S.N.R. 

Graham, J. W., Sioux City (Pensacola, Fla.) Lt. Comdr., U.S.N.R. 

Grossman, M. D., Sioux City (APO 33, San Francisco, 

Cal.) .Capt., A.U.S. 

Harris, D. M., Sioux City (Camp Shelby, Miss.) ..... Capt., A.U.S. 

Heffernan, C. E., Sioux City (Fairmont, Nebr.) Capt., A.U.S. 

Hicks, W. K., Sioux City (Spokane, Wash.) Major, A.U.S. 

Honke. E. M., Sioux City (Palm Springs, Cal.) Major, A.U.S. 

Kaplan. David, Sioux City (APO 36, New York, 

N. Y.) Capt., A.U.S. 

Knott, P. D., Sioux City (Camp Crowder, Mo.) Capt., A.U.S. 

Knott, R. C., Sioux City (APO 403, New York, 

N. Y.) ..Major, A.U.S. 

Krigsten, W. M., Sioux City (Springfield. Mo.) .. .Lt. Col., A.U.S. 

Lande, J. N.. Sioux City (APO 63. New York. N. Y.) Major, A.U.S. 

Martin, R. F., Sioux City (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Mattice, L. H.. Danbury (APO 713, San Francisco, 

Cal.) :1st Lt., A.U.S. 

McCuistion, H. M., Sioux City (APO 209, New York, 

N. Y.) Capt., A.U.S. 

Mugan, R. C.. Sioux City (Miami Beach. Fla.) Capt., A.U.S. 

Osincup, P. W., Sioux City (APO 520, New York, 

N. Y.) Capt.. A.U.S. 

Rarick, I. H., Sioux City (Camp Pinedale, Cal.) .... Capt., A.U.S. 

Reeder. J. E.. Jr., Sioux City (APO 209, New York, 

N. Y.) Capt., A.U.S. 

Ryan, M. J., Sioux City (Topeka, Kan.) Major, A.U.S. 


Schwartz, J. W., Sioux City (APO 883, New York. 

N. Y.) Lt. Col., A.U.S. 

Tracy, J. S., Sioux City (Camp Van Dorn, Miss.) . . . .Major, A.U.S. 
Worth County 

Westly, G. S., Manly (APO 4580, San Francisco, 

Cal.) Major, A.U.S. 

Wright County 

Aagesen, C. A., Dows (APO 383, New York, N, Y.) 

Capt., A.U.S. 

Bird, R. G., Clarion (Fleet PO, San Francisco, 


Cal.) Lt. Comdr., U.S.N.R. 

Doles. E. A., Clarion (Spokane, Wash.) Capt., A.U.S. 

Gorrell, R. L., Clarion (Denver, Colo.) ... .P.A. Surg., U.S.P.H.S. 
Leinbach, S. P., Belmond (Farragut Air Base, Idaho) 

Missildine, W. H., Eagle Grove (APO 25, San Francisco, 

Cal.) Capt., A.U.S. 


(♦) Reported missing in action. 

(t) Reported killed in action. 

(t) Reported prisoner of war. 

EXAMINATIONS FOR THE AMERICAN BOARD 
OF OBSTETRICS AND GYNECOLOGY 

The next written examination and review of case 
histories (Part I) for all candidates will be held in 
vario.us cities of the United States and Canada on 
Saturday, February 3, 1945, at 2:00 p. m. 

Arrangements will be made so far as is possible 
for candidates in military service to take the Part I 
examination (written paper and submission of case 
records) at their places of duty, the written exami- 
nation to be proctored by the Commanding Officer 
(medical) or some responsible person designated by 
him. Material for the written examination will be 
sent to the proctor several weeks in advance of the 
examination date. Candidates for the February 3, 
1945, Part I examination, who ai’e entering military 
service, or who are now in service and may be as- 
signed to foreign duty, may submit their case records 
in advance of the above date, by forwarding them 
to the office of the Board Secretary. All other can- 
didates should present their case records to the 
examiner at the time and place of taking the written 
examination. 

The office of the Surgeon-General (U. S. Army) 
has issued instructions that men in service, eligible 
for Board examinations, be encouraged to apply and 
that they may request orders to detached duty for 
the purpose of taking these examinations whenever 
possible. 

All candidates will be required to take both the 
Part I examination, and the Part II examination 
(oral-clinical and pathology examination). Candi- 
dates who successfully complete the Part I exami- 
nation proceed automatically to the Part II examina- 
tion to be held later in the year. 

Notice of the exact time of the Part II examina- 
tions will be sent all candidates well in advance of 
the examination date. Candidates in military or 
naval service are requested to keep the Secretary’s 
office informed of any change in address. 

If a candidate in service finds it impossible to pro- 
ceed with the examinations of the board, deferment 
without time penalty will be granted under a waiver 
of our published regulations as they apply to civil- 
ian candidates. 

Applications for the 1945 examinations are now 
closed. 

For further information and application blanks, 
address Dr. Paul Titus, Secretary, 1015 Highland 
Building, Pittsburgh 6, Pennsylvania. 


28 JouRNAf, oi' Towa State Medical Society January. 1945 



COUNTY MEDICAL SOCIETY OFFICERS 

county 

president 

SECRETARY 

DEPUTY COUNCILOR 

Adair 

,R. E. Wiley, Fontanelle 

A. S. Bowers, Orient. . . 

A. S. Bowers, Orient 

Adams 

A. W. Brunk, Prescott 

J. H. Wallahan, Corning 

.W. F. Amdor, Carbon 

Allamakee 

. J. W. Myers, Postville 

J. W. Thornton, Lansing 

.J. W. Thornton, Lansing 

Appanoose 

.J. C. Donahue, Centerville 

R. L. Fenton, Centerville 

.C. S. Hickman, Centerville 

Audubon 

,P. E. James, Elkhorn 

W. H. Halloran, Audubon 

• L. E. Jensen, Audubon 

Benton 

.N. B. Williams. Belie Plaine 

D. A. Dutton, Van Horne 

.N. B. Williams, Belle Plaine 

Black Hawk 

.H. A. Bender, Waterloo 

S. A. Barrett, Waterloo 

• A. J. Joynt, Waterloo 

Boone 

. A. B. Deering, Boone 

B. T. Whitaker. Boone 

,J. O. Ganoe, Ogden 

Bremer 

. O. C. Hardwig, Waverly 

M. N. Gernsey, Waverly 

,F. R. Sparks, Waverly 

Buchanan 

.N. L. Hersey, Independence 

J. W. Barrett, Jr., Independence. 

.C. W. Tiflball, Independence 

Buena Vista 

. A. B. Carstensen, Linn Grove - - . . 

T. R. Campbell, Sioux Rapids. .. . 

.H. E. Farnsworth, Storm Lake 

Butler 

.J. G. Evans, New Hartford 

F. F. McKean, Allison 

.Bruce Ensley, Shell Rock 

Calhoun 

,P. W. Van Metre, Rockwell City. . 

.D. C. Carver. Rockwell City 

.R. G. Hinrichs, Manson 

Carroll 

. A. R. Anneberg, Carroll 

P. D. Anneberg, Carroll 

. W. L. McConkie, Carroll 

Cass 

,G. A. Alliband, Atlantic 


. W. S. Greenleaf, Atlantic 

Cedar 

Fred Montz. Lowden 

J. E. Smith. Clarence 

,E. J. Van Metre, Tipton 

Cerro Gordo 

. S. A. O’Brien. Mason City 

R. E. Smiley, Mason City 

,G. J. Sartor, Mason City 

Cherokee 

. C. W. Ihle, Cleghorn 

D. C. Koser, Cherokee 

,C. H. Johnson, Cherokee 

Chickasaw 

.Nicholas Schilling’, New Hampton 

J. E. Murtaugh, New Hampton.. 

,P. E. Gardner, New Hampton 

Clarke 

.F. S. Bowen, Woodburn 

, C. R. Harken, Osceola 

. H. E. Stroy, Osceola 

Clay 

.T. H. Johnston, Spencer 

.C. C. Collester, Spencer 

,J. M. Sokol, Spencer 

Clayton 

J. C. Brown, Littleport 

.P. R. V. Homniel, Elkader 

.P. R. V. Hommel, Elkader 

Clinton 

.A. K. Meyer. Clinton 

. E. V. Donlan, Clinton 

.R. F. Luse, Clinton 

Crawford 

. E. V. Zaeske, Charter Oak 

Dora E. K. Zaeske, Charter Oak. 

. C. L. Sievers, Denison 

Dallas-Guthrie 

. W. V. Thornburg, Gufhrie Center 

. S. J. Brown, Panora 

.E. J. Butterfield, Dallas Center 
S. J. Brown, Panora 

Davis 

.C. H. Cronk, Bloomfield 

H. C. Young, Bloomfield 

.H. C. Young, Bloomfield 

Decatur 

.H. M. Hills, Lamoni 

• K. R. Brown. Lamoni 

F. A. Bowman, Leon 

Delaware 

. C. B. Rogers, Eariville 

Paul Stephen, Manchester 

,J. K. Stepp, Manchester 

Des Moines 

. D. F. Huston, Burlington 

W. R. Lee, Burlington 

• F. G. Ober, Burlington 

Dickinson 

•T. L. Ward, Arnolds Park 

Ruth F. Wolcott, Spirit Lake... 

,T. L. Ward, Arnolds Park 

Dubuque 

•H. E. Thompson, Dubuque 

J. W. Lawrence, Dubuque 

,J. C. Painter, Dubuque 

Emmet 

..C. E. Birney, Estherville 

L. W. Loving, Estherville 

.S. C. Kirkegaard, Estherville 

Fayette 

.C. C. Hall, Maynard 

• A. F. Grandfnetti, Oelwein 

■ C. C. Hall, Maynard 

Floyd 


R. A. Fox, Charles City 

,R. A. Fox, Charles City 

Franklin 

.J. C. Powers, Hampton 

. F. L. Siberts, Hampton 

.J. C. Powers, Hampton 

Fremont 

• Ralph Lovelady. Sidney 

A. E. Wanamaker, Hamburg.... 

.A. E. Wanamaker, Hamburg 

Greene 

. .L. C. Nelson, Jefferson 

J. R. Black, Jefferson 


Grundy 

. C. H. Bartruff, Reinbeck 

. G. A. Biebesheimer, Reinbeck,... 

,W. 0. McDowell, Grundy Center 

Hamilton 


M. B. Galloway, Webster City. . . 

.M. B. Galloway, Webster City 

Hancock-Winnebago 

• C. V. Hamilton, Garner 

W. F. Missman, Klemme 

. C. V. Hamilton, Garner 
G. F. Dolmage, Buffalo Center 

Hardin 

Harrison 

. G. A. Blaha, Whitten 

.R. H. Cutler, Little Sioux 

, W. E. Marsh, Eldora 

.F. H. Hanson, Magnolia 

.F. N. Cole, Iowa Falls 

Hen/y 

. S. W. Huston, Mt. Pleasant 

J. S. Jackson, Mt. Pleasant 

.S. W. Huston, Mt. Pleasant 

Howard 

.W. A. Bockoven, Cresco 

.F. E. Giles. Cresco 

,W. A. Bockoven, Cresco 

Humboldt 

.L. R. 'Turner, Renwick 

.C. A. Newman, Bode 

. I. T. Schultz, Humboldt 

Ida 

. H. H. Harris, Battle Creek 

. W. P. Crane. Holstein 

.E. S. Parker, Ida Grove 

Iowa 

. E. L. Hollis, Marengo 



Jackson 

.B. B. Dwyer, Preston 

■ F. J. Swift, Maquoketa 


Jasper 

. R. F. Freeh, Newton 

,T. D. Wright. Newton 

. R. W. Wood, Newton 

Jefferson 

.K. G. Cook, Fairfield 

I. N. Crow, Fairfield 

I. N. Crow, Fairfield 

Johnson 

. ,M. L. Floyd, Iowa City 

R. H. Flocks, Iowa City 

• G. C. Albright, Iowa City 

Jones 

, ,J. D. Paul, Anamosa 

.C. R. Smith, Onslow 

.T. M. Redmond, Monticello 

Keokuk 

.T. J. G. Dulin, Sigourn^ 

.John Maxwell, What Cheer 

. C. L. Heald, Sigourney 

Kossuth 

. J. W. McCreery, Whittemore. . . . 

. M. G. Bourne, Algona 

J. G. Clapsaddie, Burt 

Lee 


. H. F. Noble, Fort Madison 

■ R. L. Feightner, Ft. Madison 
B. L. Gilfillan, Keokuk 

Linn 

. B. J. Moon, Cedar Rapids 

,D. S. Challed, Cedar Rapids 

.B. F. Wolverton, Cedar Rapids 

Louisa 

. .J. W. Pence, Columbus Junction . 

.L. E. Weber, Wapello 

.J. H. Chittum, Wapello 

Lucas 

. H. D. Jarvis, Chariton 

. R. E. Anderson, Chariton 

• S. L. Throckmorton, Chariton 

Lyon 


J. H. Sherlock, Rock Rapids 

,G. M. DeYoung, George 

Madison 

. H. E. Carver, Earlham 

. E. M. Olson, Winterset 

• C. B. Hickenlooper. Winterset 

Mahaska 

. ,L. F. Catterson, Oskaloosa 

. F. A. Gillett, Oskaloosa 

.L. F. Catterson, Oskaloosa 

Marion 

. F. M. Roberts, Knoxville 

. E. C. McClure, Bussey 

. E. C. McClure. Bussey 

Marshall 

. .B. S. Wells, Marshalltown 

. G. M. Johnson. Marshalltown... 

• A. D. Woods, State Center 

Mills 

. T. B. Lacey. Glen wood 

. I. U. Parsons. Malvern 

.D. W. Harman, Glenwood 

Mitchell 

. G. E. Krepelka, Osage 

J. 0. Eiel, Osage 

• T. S. Walker, Riceville 

Monona 

. .E. J. Liska, Ute 

. E. E. Gingles, Onawa 

• C. W. Young, Onawa 

Monroe 

. ,J. F. Stafford, Lovilia 

• T. A. Moran, Melrose 

■ T. A. Moran, Melrose 

Montgomery 

. Gladys Cooper, Red Oak 

. Velura E. Powell, Red Oak 


Muscatine 

, .L. C. Howe, Muscatine 

. J. L. Klein, Jr., Muscatine 

.T. F. Beveridge, Muscatine 

O’Brien 

. .C. A. Samuelson, Sheldon 

.W. S. Balkema, Sheldon 

. W. R. Brock, Sheldon 

Osceola 

,E. P. Farnum, Sibley 

. H. B. Paulsen. Harris 

.Frank Reinsch, Ashton 

Page 

. N. M. Johnson, Clarinda 

. J. F. Aldrich, Shenandoah 

, W. H. Maloy, Shenandoah 

Palo Alto 

•J. P. McManus, Graettinger 

. P. 0. Nelson, Emmetsburg 

,H. L. Brereton, Emmetsburg 

Plymouth 

.M. J. Joynt, Le Mars 

. L. C. O’Toole, Le Mars 

,W. L. Downing, Le Mars 

Pocahontas 

. W. E, Gower, Pocahontas 

.G. A. Everson, Rolfe 

,J. H. Hovenden, Laurens 

Polk 

. ,C. B. Luginbuhl, Des Moines.... 

. E. W. Anderson, Des Moines 

.J. B. Synhorst, Des Moines 

Pottawattamie 

. F. E. Marsh, Council Bluffs 

.G. V, Caughlan, Council Bluffs. . 

.G. N. Best, Council Bluffs 

Poweshiek 

. W. B. Phillips. Montezuma 

.C. E. Harris, Grinnell 

.C. E. Harris, Grinnell 

Ringgold 

. ,0. L. Fullerton, Redding 

.J. W. Hill, Mt. Ayr 

,E. J. Watson, Diagonal 

Sac 

..A. A. Blum, Wall Lake 

. J. W. Gauger, Early 

.J. R. Dewey, Schaller 

Scott 

. A. A. Garside, Davenport 

. L. J. Miltner, Davenport...... 

• A. P. Donohoe, Davenport 

Shelby 

. .J. P. McGowan, Harlan 



Sioux 

..A. L. Lock, Rock Valley 

,Wm. Doornink, Orange City 

,Wm. Doornink, Orange City 

Story 

..Julia Cole, Ames 

■ W. B. Armstrong, Ames 

• Bush Houston. Nevada 

Tama 

. .F. W. Gessner, Dysart 

.G. M. Dalbey, Traer 

.A. A. Pace, Toledo 

Taylor 

. .C. E. Buckley, Blockton 

.J. H. Gasson, Bedford 

,G. W. Rimel, Bedford 

Union 

. J. A. Liken, Creston 

,C. E. Sampson, Creston 


Van Buren 

. Roscoe Pollock, Douds-Leando. . 

.J. A. Craig, Keosauqua 

• L. A. Coffin, Farmington 

Wapello 

, V. S. Downs, Ottumwa 

.L. A. Taylor, Ottumwa 

.E. B. Hoeven, Ottumwa 

Warren 

. .G. A. Jardine, New Virginia.... 

• C. H. Mitchell, Indianola 

.0. H. Mitchell, Indianola 

Washington 

. .W. L. Alcorn, Washington 

.W. S. Kyle, Washington 

. E. D. Miller, Wellman 

Wayne 

. ,D. R. Ingraham, Sewal 

.C. F. Brubaker, Corydon 

,L. B. Calbreath, Humeston 

Webster 

. E. F. Beeh, Fort Dodge 

.P. C. Otto, Fort Dodge 

,H. E. Nelson. Dayton 

Winneshiek 

. V. J. Horton, Calmar 

.R. M. Dahlquist, Decorah 

. L. C. Kuhn, Decorah 

Woodbury 

. R. N. Larimer. Sioux City 

,F. D. McCarthy, Sioux City.... 

,D. B. Blume, Sioux City 

Worth 

. .B. H. Oaten, Northwood 

,M. P. Allison, Northwood 

• S. S. Westly, Manly 

Wright 

. G. E. Schnug, Dows 


• J. H. Sams, Clarion 1-1-43 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


29 


WOMAN’S AUXILIARY NEW: 


Mrs. Keith M. Chapler, Chairman of Press and Publicity Committee, Dexter, Iowa 


President — Mrs. Jay C. Decker, Sioux City 
President-Elect — Mrs. Soren S. Westly, Manly 
Secretary — Mrs. Allen C. Starry, Sioux City 
Treasurer — Mrs. Arthur E. Merkel, Des Moines 


STATE COMMITTEES 

Advisory Council 


Dr. Edward A. Hanske, Chairman Bellevue 

Dr. Ralph Lovelady Sidney 

Dr. Frederick W. Mulsow Cedar Rapids 

Ol!GANIZ.^TI0N 

Mrs. Soren S. Westly, Chairman Manly 

Mrs. Allan G. Felter Van Meter 

Mrs. Henry M. Pahlas Dubuque 

Mrs. Robert G. Hinrichs Manson 

Mrs. Ivan K. Sayre St. Charles 

Program 

Mrs. Fred Moore, Chairman Des Moines 

Mrs. Robert T. Osborn Dexter 

Mrs. Joseph B. Priestley Des Moines 

Mrs. John C. Pickard Dubuque 

Mrs. Harold C. Bastron Red Oak 

Legislation 

Mrs. James A. Downing, Chairman Des Moines 

Mrs. Paul W. Van Metre Rockwell City 

Mrs. Leo C. Nelson Jefferson 

Mrs. Elmer L. Lampe Bellevue 

Mrs. James W. Pence Columbus Junction 

Press and Puulicity 

Mrs. Keith M. Chapler, Chairman Dexter 

Mrs. Howard F. Clark Stuart 

Mrs. Marion H. Brinker ..Jefferson 

Mrs. Monroe P. Allison Northwood 

Mrs. Harry C. Willett Des Moines 

Public Relations 

Mrs. Edward H. Sibley, Chairman Sioux City 

Mrs. Gabriel S. Westly Manly 

Mrs. Earl F. Bellinger '.'.Council Bluff . 

Mrs. Philip L. Bettler Sioux City 

Mrs. John J. Tilton Maquoketa 

Revisions 

Mrs. Channing G. Smith, Chairman Grange- 

Mrs. Henry M. Pahlas Dubuque 

Mrs. Allan G. Felter Van Meter 

Mrs. Matthew J. Moes Dubuque 

Mrs. Charles A. Nicoll Panora 

Finance 

Mrs. Elbert T. Warren, Chairman Stuart 

Mrs. Arthur E. Merkel Des Moines 

Mrs. James E. Reeder Sioux City 

Mrs. Hugh B. Woods Des Moines 

Mrs. William V. Thornburg Guthrie Center 

HYGI'IA 

Mrs. Peter W. Beckman, Chairman Perry 

Mrs. Walter E. Chase Rippey 

Mrs. Abbott M. Dean Council Bluffs 

Mrs. Robert C. Osborn Dexter 

Mrs. Frank P. McNamara Dubuque 

Bulletin 

Mrs. Matthew J. Moes, Chairman Dubuque 

Mrs. Ralph E. Wiley Fontanelle 

Mrs. Walter P. Hombach Council Bluffs 

Mrs. Milo W. Moulton Bellevue 

Mrs. George W. Egerniayer Elliott 

Nurses Loan Fund 

Mrs. William R. Hornaday, Chairman Des Moines 

Mrs. Julius M. Margolin Perry 

Mrs. Jesse A. Pringle Bagley 

Mrs. Harry P. Hall Atlantic 

Mrs. Reu L. Barnett Atlantic 


Defense 


Mrs. Alvin H. Hendrickson. Chairman Sioux City 

Mrs. Frank L. Griffin Baldwin 

Mrs. Benjamin C. Hamilton .Jefferson 

Mrs. Ingmar C. Vangsness Sioux City 

Mrs. Mary Price Roberts Spirit Lake 

War Service 

Mrs. M. Charles Hennessy, Chairman Council Bluffs 

Mrs. George W. Franklin .Jefferson 

Mrs. Alfred B. Nesler Dubuque 

Mrs. David C. Carver Rockwell City 

Mrs. Daniel J. Glomset Des Moines 

Historian 

Mrs. William A. Seidler Jamaica 

P.arliambntarian 

Mrs. Edward A. Hanske Bellevue 


HEALTH QUESTIONS ANSWERED BY 
W. W. BAUER, M.D. 

1. Is nail polish harmful or beneficial to the nails? 

Nail polish itself is not harmful, but excessive 

use of the buffer, by creating heat, might be detri- 
mental. Liquid nail polishes are harmless unless 
the individual is sensitized to the pigments or the 
solvent, but excessive use of the “remover” may 
cause nails to split and break. 

2. Will going without a hat encourage the growth 
of hair or stop falling hair? Is there any harm in 
going bareheaded? 

Going hatless becomes the vogue from time to 
time, and the question arises as to whether there is 
any harm in it. Within reason, there is not, but 
exposure of the uncovered head to extreme cold in 
winter or to the powerful rays of the sun in mid- 
summer, as is often done, is silly and pointless, and 
may be dangerous. Hatlessness is no assurance of 
luxuriant foliage aloft. Too much sunlight may 
bleach and coarsen the hair. Too much water dries 
it out. 

3. What is the real cause of gray hair ? Is gray 
hair due to lack of meat in the diet? 

Nobody knows the cause. Lack of meat is not 
responsible. Hair may be dyed, at possible though 
perhaps remote risk of irritation of the skin and 
generalized poisoning, with dyes which give good- 
looking results; namely, the aniline dyes. Metallic 
dyes are either too dangerous or too inefficient to 
consider. Hair may be dyed with practically com- 
plete safety by the use of dyes whose cosmetic ac- 
ceptability is questionable. Any claim that a prep- 


30 


Journal of Iowa State Medical Society 


January, 1945 


aration of a beauty operator can do more is un- 
founded. 

4. In buying commercially canned fruits is it 
preferable to secux-e those that have been canned 
the same season? 

No, since properly canned foods keep a long time. 

5. Should one in fair health past sixty drink coffee 
each morning ? 

There is no reason why one should not unless 
specifically forbidden by a physician. 

6. What brand of bran is best? 

The commercial brand of bran chosen is of little 
consequence, especially now that bran products must 
be labeled to show the exact percentage of bran 
contained in each. The important question is 
whether the patient should have bran at all, a ques- 
tion properly decided in the physician’s consulting 
room and not on the advertising pagefe of even our 
“best” magazines. 

7. Is it necessary to give cod liver oil to children 
who are healthy and slightly overweight? 

A vitamin D preparation equivalent to cod liver 
oil should always be given to children, even if they 
are overweight, since it is the vitamin content and 
not primarily the oil which constitutes the customary 
reason for using it. 

8. Under what conditions do poisons develop in 
foods, especially those warmed over? 

Poisons may develop in foods, cooked or uncooked, 
from the growth of germs in them. Cream fillings in 
bakery goods, which are often allowed to stand to 
ripen, may become infected, and make excellent food 
for bacterial growth; such cream fillings should be 
eaten fresh only. 


DALLAS-GUTHRIE AUXILIARY MEETING 
The Woman’s Auxiliary to the Dallas-Guthrie Med- 
ical Society met October 19 at Panora with ten mem- 
bers and two guests present. The nominating 
committee presented the following names for officers 
for 1945: president, Mrs. K. M. Chapler, Dexter; 
president-elect, Mrs. E. J. Butterfield, Dallas Center; 
first vice president, Mrs. A. J. Ross, Perry; second 
vice president, Mrs. J. A. Pringle, Bagley; secretary, 
Mrs. H. W. Smith, Woodward; and treasurer, Mrs. 
W. V. Thornburg, Guthrie Center. Mrs. E. T. War- 
ren of Stuart gave an outline of the new constitution 
adopted at the national meeting in Chicago, and 
Mrs. C. A. Nicoll of Panora gave an interesting talk 
on her experiences as “An Army Wife.” A gift of 
home canned fruit and vegetables was sent to an 
invalid member of our Auxiliary. 

Mrs. P. W. Beckman, Perry 


WAR SERVICE ACTIVITIES 
It is hoped that every Auxiliary will be able under 
the guidance of its local advisory committee to 
develop a successful program for War Service. 
Questionnaires are sent out early in the year to the 
state chairmen and records of war work done are 
reported to the regional chairmen at the end of the 


year in hours and total value of war bonds and 
stamps sold. Iowa is in the North Central Region, 
which comprises twelve states: Illinois, Indiana, 
Iowa, Kansas, Michigan, Minnesota, Missouri, Ne- 
braska, Ohio, North Dakota, South Dakota, and 
Wisconsin. Mrs. Rollo K. Packard of Chicago is 
the General Chairman and Mrs. M. C. Hennessy of 
Council Bluffs is State Chairman tor Iowa. 

It is suggested that Auxiliary members participate 
in the following activities: The sale of war bonds 
and stamps; hospital service; doctor’s aide corps; 
minute maids; day nurseries for children of women 
in industry; study of nutrition and distribution of 
food; assisting at canteens and military camps; ! 
rationing- boards; Red Cross; and recruitment of 
U. S. Cadet Nurse Corps. 

Our Auxiliaries do a tremendous amount of War 
Service. The North Central Region reported 409,161 
hours of War Service and $175,245 in war bonds and 
stamps sold in 1944-1945. We hope to have a decided 
increase this year. 

Mrs. F. W. Mulsow, Regional Chairman, 
War Service Committee, 

Woman’s Auxiliary to the American 
Medical Association. 


FACTS CONCERNING HYGEIA* 

1. HYGEIA prints authentic health information. 

2. HYGEIA gives in clear, concise and simple terms 
scientific knowledge of the medical world that 
even the school child will understand. 

3. HYGEIA gives reliable information regarding 
quacks, faddists and cultists. It is a safeguard 
against ignorance. The American public squan- 
ders more than four million dollars annually on 
patent medicines. 

4. HYGEIA is packed with up-to-date reliable health 
information for the teacher. 

5. HYGEIA teaches how to form health habits in- 
telligently. 

6. HYGEIA serves as a text and reference book. 

7. HYGEIA deals with the simple but fundamental 
principles of health that affect dally living in 
homes, schools and communities. 

8. HYGEIA contains child welfare articles for 
mothers who are helping their children form 
health habits. 

9. HYGEIA gives good sound health advice to the 
business man and woman regarding how much 
and what kind of food, exercise, rest and sleep 
they should have. 

10. HYGEIA is the medium of conveying to the peo- 
ple who are not patients of the medical profes- 
sion, scientific infoi’mation concerning the pre- 
vention of disease. 

11. HYGEIA is a clearing house for health news and 
views and health activity in all parts of the world. 

12. HYGEIA gives health information, but each 
article emphasizes the intrinsic value of YOUR 
FAMILY PHYSICIAN. 


*From “Hygeia Handbook” 1944-45. 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


.31 


History of Medicine in Iowa 

Edited b\ the Historical Committee 

Dr. Walter L. Bierring, Des Moines, Chairman 
Dr. Henry G. Langworthy, Dubuque, Secretary Dr. John T. McClintock, Iowa City 
Dr. Murdoch Bannister, Ottumwa Dr. Frank E. Sampson, Creston 



Clyde A. Henry, M.D., Farson 
Part III 


(Continued from November) 


ORGANIZATION OF COUNTY MEDICAL SOCIETY 

At the beginning of the second decade, probably 
on the first or last Tuesday in May, 1853, the first 
Medical Society of Wapello County was organized 
with the following members enrolled : 

Dr. C. C. Warden, Ottumwa 
Dr. A. D. Wood, Ottumwa 
Dr. J. Williamson. Ottumwa 
Dr. \v. L. Orr, Ottumwa 
Dr. J. W. LaForce, Old Ashland 
Dr. A. R. \Wir, Agency City 
The officers selected were : Dr. C. C. Warden, 
president: Dr. A. D. Wood, vice president; Dr. 
J. Williamson, secretary. 

1 he records are somewhat confused at this 
point, owing to an item contained in volume 2, 
page 415 of the Iowa Medical Journal for the year 
1855, which is on file in the Library of the Sur- 
geon General, Washington, D. C. The article re- 
ferred to follows : 


“The Wapello County Medical Society was or- 
ganized in Ottumwa, May 26th, 1855. Those pres- 
ent : 


H. Kirkpatrick 
J. Williamson 
F. G. McClintock 
A. R. Weir 
T. J. Douglass 
C. C. Warden 
A. C. Olney 

“H. Kirkpatrick was 
Williamson, secretary. 

“Two weeks later, June- 9th, S. G. Norris and 
S. P. Johnson were made members.’’ 

It is probable that the 1855 organization re- 
ferred to above records (or should have recorded) 


J. C. Kinsey 
W. Gutch 
J. L. LaForce 
J. J. Ellison 
A. D. Wood 
J. L. Taylor 
A. Hawkins 

elected president, and J. 


the annual election of officers for the year begin- 
ning May 26, 1855, with a list of the membership 
of the Society at that time. However, a search of 
the files of the Ottumwa Courier, which is com- 
plete for the month of May, 1853, has nothing to 
say concerning the organization of a Wapello 
County Medical Society. The files of the Courier 
for the summer of 1855 are not complete, the is- 
sues preserved being as follows : April 19, May 
10, June 11 and 28, July 5 and 12. In none of 
these issues is the Wapello County Medical Society 
mentioned or referred to. 

Dr. Fairchild’s History of Medicine in lozua 
does not mention the 1855 meeting but fixes the 
date of the organization as of May, 1853. Dr. 
A. O. Williams of Ottumwa provided Dr. Fair- 
child with this information. Dr. Williams, whose 
wife was a daughter of W. H. Warden, founder 
and publisher of the Ottumw'a Courier for many 
years, was one of the outstanding members of the 
profession in Wapello County for nearly a half 
century. He had a broad literary education and 
was the type of man who would carefully scruti- 
nize every bit of evidence available, whether docu- 
mentary or traditional, before a definite conclusion 
would be subscribed to. 

There is more than a suspicion of faulty typog- 
raphy in the 1855 version, in which appears the 
names of “J. C. Kinsey” and “J. L. LaForce.” 
llinsey was the name, not Kinsey; and J. W., not 
J. L., was the LaForce referred to. Was a care- 
less reportorial effort responsible for the addition 
of two names to the list that nowhere else appear 
in the records of the medical history of the Coun- 
ty? The names referred to are: F. G. McClin- 
tock. and J. J. Ellison. 

That Dr. C. C. M’arden was the first president 


32 


JoruNAi. OF Iowa State Medical Society 


January, 1945 


of tlie Wapello County Medical Society is an un- 
disputed tradition in this community, both lay and 
professional. It must be assumed, therefore, that 
the account of the 1855 meeting, which appeared 
in the Iowa Medical Journal of that year, is faulty 
and incorrect. 

After continuous functioning over a period of 
eight years, the Society was suddenly disrupted by 
the Civil War. Detailed activities of the organiza- 
tion during those eventful years before the war are 
legendary, all records having been lost or de- 
stroyed. 

CIVIC AND STATE MEDICAL BUILDERS 

The activities of many pioneer physicians are 
recorded in the varied fields of civilian enterprise. 


and, together with Drs. Thrall, Orr, Williamson 
and Hinsey as collaborating members, controlled 
the administration of educational interests for 
more than a quarter of a century. The first inde- 
pendent school meeting of record was held in the 
office of Dr. Thrall. The first principal of the 
Ottumwa public school was Dr. Orr, who served 
from 1856 to 1858, and then resigned to resume 
the practice of medicine. 

Nor was that all. This little group of pioneer 
physicians not only controlled the destinies of the 
medical profession of Wapello County, and edu- 
cational interests, in the early years, but their dom- 
inating influence in public affairs made a lasting 
impression in city and county politics. Dr. Orr 
was elected mayor of Ottumwa four times: Dr. 



EARLY PIONEER DOCTORS 

Upper, left to right: “Old Doc” Buck, W. L. Orr, C. C. Warden, A. D. Wood, S. E. O’Neill. 

Lower, left to right: D. C. Dinsmore, A. R. Weir, Wm, Gutch, F, M, McCrea, A, B. Comstock, James Nosier. 


Dr. Nosier, Dr. Flint, Dr. Yoemans and Dr. 
Wood were four of the twenty-odd delegates to 
the Plankroad Convention held in Mt. Pleasant, 
February 27, 1850, which would have involved 
the greatest single highway improvement program 
in the county except for the hard surfacing pro- 
gram of recent years. 

Dr. C. C. Warden retired from practice in 1856, 
after thirteen years of service. His influence and 
personal services had much to do with the estab- 
lishment of a sound and successful public school 
system in Ottumwa at an early date. He served 
as president of the School Board for twelve years 


Hinsey served as county coroner four years, was 
a member of the board of supervisors one term, 
and was chairman of the meeting that organized 
the Republican party in Wapello County in 1856; 
and Dr. Thrall was clerk when, in 1868, the city- 
of Ottumwa was reorganized under the general 
incorporation laws of the state. 

Nor yet was that all. Three of them — Dr. 
Thrall, Dr. Williamson and Dr. Hinsey — were 
each destined to receive the highest gift of honor 
the Iowa State Medical Society can bestow, name- 
ly, its presidency. Each served with distinction 
his allotted term. be continued) 


VoL. XXX\^ No. 1 


Journal ok Iowa State Medical Society 


3 .^ 


THE JOURNAL BOOK SHELF 


BOOKS R 

LIPPINCOTT’S QUICK REFERENCE BOOK FOR MEDICINE 
AND SURGERY, a Clinical, Diagnostic, and Therapeutic Di- 
gest of General Medicine, Surgery, and the Specialties, 
Compiled Systematically from Modern Literature — By George 
E. Rehberger, M.D. Twelfth edition. J. B. Lippincott Com- 
pany, Philadelphia, 1944. Price, $15.00. 

OPERATIONS OF GENERAL SURGERY— By Thomas G. Orr, 
M.D., Professor of Surgery, University of Kansas School of 
Medicine, Kansas City, Kansas. W. B. Saunders Company, 
Philadelphia, 1944. Price, $10.00. 

ARTHRITIS AND ALLIED CONDITIONS— By Bernard I. Corn- 
roe, M.D., Associate in Medicin,e, University of Pennsylvania, 
Senior Ward Physician and Chief of the Arthritis Clinic, 
Hospital of the University of Pennsylvania. Third edition, 
enlarged and thoroughly revised. Lea & Febiger, Phila- 
delphia, 1944. Price, $12.00. 

TABOR’S DICTIONARY OF GYNECOLOGY AND OBSTET- 
RICS — By Clarence Wilbur Taber, Medical Editor and au- 
thor of Taber’s Cyclope<lic Medical Dictionary, Taber’s Con- 
densed Medical Dictionary, and Dictionary of Food and Nu- 
trition : with the collaboration of Mario A. Castallo, M.D., 
Assistant Professor of Obstetrics, Jefferson Medical College, 
Gynecologist to St. Mary’s and St. Agnes’ Hospitals, Ob- 
stetrician to St. Mary’s Hospital. F. A. Davis Company, 
Philadelphia, 1944. Price, $3.50. 

THE ART OF RESUSCITATION— By Paluel J. Flagg, M.D., 
Chairman, Committee on Asphyxia, American Medical As- 
sociation ; President and Founder of the Society for the Pre- 
vention of Asphyxial Death, Inc. Reinhold Publishing Cor- 
poration, New York, 1944. Price, $5.00. 


BOOK R 

DISEASES OF THE DIGESTIVE SYSTEM 

Edited by Sidney A. Portis, M.D., asso- 
ciate professor of medicine, University of 
Illinois Medical School (Rush) ; attending 
physician, Michael Reese Hospital; con- 
sulting physician. Cock County Hospital; 
consultant in medicine to the Institute of 
Psychoanalysis, Chicago. Second edition. 

Lea & Febiger, Philadelphia, 1944. Price, 

$ 11 . 00 . 

This second edition of Dr. Portis’s book has 
enough outstanding features to make it acceptable 
to both students and practitioners. It is difficult 
to see how any more gastro-enterology could be 
crammed into one volume of 932 pages. Each of the 
fifty contributors is outstanding in some field of 
gastro-enterology; their clear-cut, concise contri- 
butions make the book authoritative. 

The arrangement of the subject matter is excel- 
lent. The author recognizes that a knowledge of 
physiology is essential before one can obtain a 
proper understanding of pathology and clinical 
syndromes. He, therefore, properly prefaces the 
discussion of disease of various organs with a chap- 
ter on physiology. 

This edition also recognizes the ever increasing 
importance of psychosomatic aspects of gastro-intes- 
tinal symptoms and properly includes well written 
chapters on this subject. In addition to the usual 
chapters on the history of and diseases of the diges- 
tive system, there are very important chapters which 
discuss briefly and clearly the gastro-intestinal man- 


E C E I V E D 

THE 1944 YEAR BOOK OF GENERAL MEDICINE— Edited 
by George F. Dick, M.D., J. Burns Amberson, M.D., George 

R. Minot, M.D., William B. Castle, M.D., William D. Stroud, 
M.D., and George B. Eusterman, M.D. The Year Book 
Publishers, Chicago, 1944. Price, $3.00. 

CONTROL OF PAIN IN CHILDBIRTH— By Clifford B. Lull. 
M.D., Clinical Professor of Obstetrics, Jefferson Medical Col- 
lege, Assistant Director, Philadelphia Lying-In Unit, Pennsyl- 
vania Hospital ; and Robert A. Hingson, M.D., Surgeon, U. 

S. Public Health Service, Director, Postgraduate Medical 
Course, Philadelphia Lying-In Unit, Pennsylvania Hospital. 
With an introduction by Norris W. Vaux, M.D., Obstetri- 
cian-in-Chief, Philadelphia Lying-In Unit, Pennsylvania Hos- 
pital. J. B. Lippincott Company, Philadelphia, 1944. Price, 
S7.50. 

PRINCIPLES AND PRACTICE OF SURGERY— By W. Wayne 
Babcock, M.D., Emeritus Professor of Surgery, Temple 
University, Acting Consultant, Philadelphia General Hos- 
pital ; "with the collaboration of thirty-seven members of the 
faculty of Temple University. Lea & Febiger, Philadelphia, 
1944. Price, .$12.00. 

MODERN CLINICAL SYPHILOLOGY — By John H. Stokes, 
M.D., Professor of Dermatology and Syphilology, School of 
Medicine and Graduate School of Medicine, University of 
Pennsylvania : Herman Beerman, M.D., Assistant Professor 
of Dermatology and Syphilology, School of Medicine and 
Graduate School of Medicine, University of Pennsylvania: 
and Norman R. Ingraham, Jr., M.D., Assistant Professor 
of Dermatology and Syphilology, School of Medicine, Uni- 
versity of Pennsylvania. Third edition, reset. W. B. Saun- 
ders Company, Philadelphia, 1944. Price, $10.00. 


E V I E W S 

ifestations of extra-abdominal and systemic disease, 
such as urologic disease, neurogenic disturbances of 
the intestinal tract, allergy, and endocrinologic man- 
ifestations in the gastro-intestinal tract. 

The 182 engravings are amply sufficient to illus- 
trate the clinical discussions, and the roentgeno- 
grams are particularly well chosen and distinct. 
References are sufficient for all practical purposes 
and the index is complete. » 

The reviewer knows of no other one volume on 
gastro-intestinal disease which so thoroughly meet.' 
the demands of both practitioner and student. 

A. A. S. 


A TEXTBOOK OF PATHOLOGY 

By Robert Allan Moore, Edward Mal- 
linckrodt. Professor of Pathology, Washing- 
ton University School of Medicine, St. Louis, 
Missouri. W. B. Saunders Company, Phila- 
delphia, 1944. Price, $10.00. 

In most textbooks of pathology the author is con- 
tent to describe the commoner lesions and discuss 
the more usual diseases. This makes them more 
practical for the medical student but of less use to 
the pathologist or practicing physician who may be 
confronted with a rare tumor or a baffling syndrome. 

In this volume. Dr. Moore has been more ambitious 
and has made the attempt to cover the whole field 
of pathologic changes. And, though this might 
seem an impossible task, he has in large part suc- 
ceeded and produced a work of exceptional value. 
He avoids undue sketchiness by several means. In 


34 


JoiTRNAr, oi' Iowa State Medical Society 


January, 1945 


most controversial matters he simply states the 
diverse opinions and lets it go at that. He also uses 
a terse and compact style, which iiacks as much in- 
formation as ))ossible into each sentence. This is 
a relief from the prolixity of much medical writing- 
but does have the disadvantage that certain points 
are not adequately emphasized. Certain chapters are 
shorter than one could wish but it is too much to 
expect everything- in a book of only 1,300 pages. 
The illustrations are numerous and of uniform ex- 
cellence, and it goes without saying that the results 
of recent research are incorporated in the text. 

To our mind. Dr. Moore’s treatise is a reference 
work rather than a textbook; but we need the former 
much more than we do the latter. Since the field 
of morbid anatomy and morbid physiology is so vast 
and so complex, we should have a publication in 
which every, or almost every condition is described 
— the usual, the unusual, and the rare. May we 
hope that future editions will be expanded into two 
or more volumes and form the encyclopedia of pa- 
thology which is so much needed ? 

J. S. W. 


NEW AND NONOFFICIAL REMEDIES, 1944 
Containing descriptions of the articles 
which stand accepted by the Council on 
Pharmacy and Chemistry of the Amei’ican 
Medical Association on January 1, 1944. 
American Medical Association, Chicago, 
1944. Price, $1.50. 

The current volume of New and Nonofficial Rem- 
edies reflects two important and forward looking 
decisions of the Council; namely, to use the metric 
system exclusively in all its publications and to 
consider for acceptance contraceptive preparations 
offered for use as prescribed by physicians. These 
decisions in turn reflect the vigorous and progres- 
sive leadership of the Council in the service of medi- 
cine. 

The chapter on contraceptives is quite comprehen- 
sive; -with the acceptance of more preparations, it 
will undoubtedly assume a large place in New and 
Nonofficial Remedies. The Council has thus far ac- 
cepted some contraceptive jellies and creams, con- 
traceptive diaphragms, diaphragm inserts, syringe 
applicators, and fitting rings. It is understood that 
a number of additional preparations have been sub- 
mitted for Council consideration since the book went 
to press. This chapter represents a courageous and 
long-needed innovation. 

Some of the new preparations which appear in 
this volume are: Succinylsulfathiazole, a new sul- 
fonamide, a proprietary brand being “Sulfasuxi- 
dine;” Diodrast Concentrated Solution, a preparation 
of the already accepted Diodrast, for use in a spe- 
cial diagnostic procedure for -visualization of the 
circulatory system and also cholangiography; a prep- 
aration of Sodium Benzoate for use as a liver func- 
tion test; Mersalyl and Theophylline, accepted un- 
der the name Salyrgan-Theophylline Tablets, pro- 


posed as an adjunct to intravenous injection of the 
already accepted drug; Zinc Insulin Crystals and 
Zinc Insulin Injection Crystalline; Tetanus Toxoid; 
and Concentrated Oleovitamin A and D, a dosage 
of the pharmacopoeial preparation. 

A glance at the preface shows that certain general 
articles have been revised to bring them up to date. 
More or less important revisions have been made of 
the following chapters : Barbituric Acid Derivatives, 
Estrogenic Substances; Parathyroid; Ovaries; Sul- 
fonamide Compounds; Vitamins, especially the sec- 
tions, Vitamin B Complex and Vitamin D. In this 
connection it is worth noting that each chapter in 
the book is reviewed annually, or more often if indi- 
cated, by the responsible referee for such revision. 

This volume is of paramount interest to all those 
concerned with rational and modern drug therapy. 


METASTASES 
Medical and Surgical 
By Malford W. Thewlis, M.D., Attending 
Specialist in General Medicine, United 
States Public Health Hospitals, New York 
City; Attending Physician, South County 
Hospital, Wakefield, Rhode Island; Special 
Consultant, Rhode Island Department of 
Public Health. Foreword by Hubert A. 
Royster, M.D., Honorary Chief Surgical 
Service, Rex Hospital; Chief of Staff, St. 
Agnes Hospital; Consulting Surgeon, Dix 
Hill State Hospital. Charlotte Medical 
Press, Charlotte, North Carolina, 1944. 
Price, $5.00. 

This book of 230 pages is a tabulation of the sites 
from which and to which metastases occur. A brief 
first section is readable and informative, the rest of 
the book is a mere outline suitable for quick refer- 
ence from a reading of which no more can be gained 
than from a dictionary. 

The five chapters are entitled: Neoplasms, Infec- 
tions, Infectious Diseases, Miscellany (which in- 
cludes blood dyscrasias and other diseases), and 
Regional Metastases. Under these headings are 
listed alphabetically the type or site of primary 
lesions, the source of metastases and the location. 
The more common sites of metastasis are italicized 
but might better be listed in order of frequency 
since nothing is gained by their alphabetic enumera- 
tion. A useful addition might be some indication of 
the tendencies of individual gro-wths and their rela- 
tive rate of metastasis. 

Attention is directed to the fact that not onlj 
malignant growths but abscesses, infections and in- 
flammations are often “transferred from a primary 
focus to a distant site.” Yet, even with this broad 
definition of metastasis, the author omits direct ex- 
tension of tumor cells but includes leukemias. 

There is an extensive and useful bibliography and 
an index. The drawings are too small and too 
crowded, the number of errata corrected indicates 
rather poor proofreading, and the printing could 
have been greatly improved. E. G. Z. 


VoL. XXXV, No. 1 


Journal of Iowa State Medical Society 


35 


SOCIETY PROCEEDINGS 


Adair County 

Members of the Adair County Medical Society met 
at the Greenfield Hotel in Greenfield Monday eve- 
ning, December 11, for a dinner and business meeting. 
Following dinner a report was given and discussed 
i-egarding the Medical Service Plan recently pre- 
sented at the Special Meeting of the House of Dele- 
gates in Des Moines. Officers elected for the en- 
suing year include Dr. Ralph E. Wiley of Fonta- 
nelle, president; Dr. Arthur S. Bowers of Orient, 
secretary-treasurer; and Dr. Edna K. Sexsmith 
Harper of Greenfield, delegate. 

A. S. Bowers, M.D., Secretary 


Butler County 

Members of the Butler County Medical Society 
entertained their wives at a turkey dinner Tuesday 
evening, November 14, at the Cashman Cafe in Alli- 
son. Entertainment included interesting moving 
pictures shown by Dr. Edwin M. Mark of Clarksville. 


Des Moines County 

The Des Moines County Medical Society held its 
annual meeting Tuesday evening, December 12, at 
Hotel Burlington in Burlington. Officers elected to 
serve the Society during 1945 include Dr. Daniel F. 
Huston, president; Dr. Jonathan H. Murray, vice 
president; and Dr. Wayne R. Lee, secretary-treas- 
urer. All officers are of Burlington. 


Johnson County 

The December meeting of the Johnson County 
Medical Society was held in Iowa City at Hotel Jef- 
ferson, Wednesday, December 6, at 6:00 p. m. The 
annual election of officers was held following dinner. 
Those named to serve the Society during 1945 in- 
clude Dr. Mark L. Floyd, president; Dr. Stuart C. 
Cullen, vice president; Dr. Rubin H. Flocks, secre- 
tary-treasurer; Drs. Ewen M. MacEwen, Andrew W. 
Bennett, and John W. Dulin, delegates; and Drs. 
Paul A. Reed, Wilbur R. Miller, and Raphael J. 
Hennes, alternate delegates. All officers are of Iowa 
City with the exception of Dr. Hennes who is lo- 
cated in Oxford. 

The scientic program consisted of an interesting 
paper by Major Hanson H. Leet, M.C., Chief of the 
Neuropsychiatric Service in La Garde General Hos- 
pital in New Orleans, Louisiana, entitled War Neuro- 
ses and Postwar Problems. The paper was discussed 
by Jacques S. Gottlieb, M.D., of the Psychopathic 
Hospital and Adolph L. Sahs, M.D., of the Depart- 
ment of Neurology. 

Rubin H. Flocks, M.D., Secretary 


Mahaska County 

A meeting of the Mahaska County Medical So- 
ciety was held in Oskaloosa at Mahaska Hospital 
.Wednesday evening, December 6. The guest speak- 
er of the evening was William M. Spear, M.D., Su- 
perintendent of the State Sanatorium at Oakdale, 
who spoke on Advancement in Diagnosis and Ther- 
apy of Pulmonary Tuberculosis. 


Monroe County 

The annual meeting of the Monroe County Medi- 
cal Society was held in Albia at Mother’s Kitchen, 
Thursday noon, December 7. The business meeting 
consisted of a discussion of the proposed Medical 
Service Plan for Iowa and the election of officers 

■pHT* 1 

* Thomas A. Moran, M.D., Secretary 


Pottawattamie County 

The Pottawattamie County Medical Society held 
a meeting in Council Bluffs at Hotel Chieftain Tues- 
day, November 21, at 6:30 p. m. Nathaniel 
G. Alcock, M.D., Professor of Urology at the State 
University of Iowa College of Medicine, was the 
guest speaker of the evening and presented a paper 
on Diseases of the Prostate Gland. 

The annual meeting of the Pottawattamie Society 
was held Thursday evening, December 14. Dr. 
Frederick E. Marsh was named president; Dr. Purl 
E. Reed, vice president; and Dr. Gerald V. Caughlan, 
secretary-treasurer. Dr. Aldis A. Johnson was re- 
elected to the board of censors. All officers are of 
Council Bluffs. 


Scott County 

The December meeting of the Scott County Medi- 
cal Society was held in Davenport Tuesday, Decem- 
ber 5, at 6:00 p. m. at the Lend-A-Hand Club. The 
guest speaker of the evening was Dabney H. Kerr, 
M.D., Professor of Radiology at the State Univer- 
sity of Iowa College of Medicine, who discussed 
Roentgenologic Studies of Gastro-Intestinal Dis- 
eases. Miltner. M.D., Secretary 


Story County 

The Story County Medical Society held its annual 
election of officers Wednesday evening, December 13, 
with the following results: Dr. Julia Cole of Ames, 

president; Dr. Frank W. Cowgill of Nevada, vice 
president; Dr. William B. Armstrong of Ames, secre- 
tary-treasurer; Dr. Earl B. Bush of Ames, delegate; 
and Dr. Bush Houston of Nevada, alternate. 


36 


Journal of Iowa State Medical Society 


January, 1945 


Wapello County 

The Wapello County Medical Society will hold its 
January ineetinpfs in Ottumwa on the second and 
sixteenth of the month. The first meeting, Tuesday, 
January 2, will be held at St. Joseph Hospital. Sci- 
entific motion pictures will comprise the program. 
A film, entitled Simple Goiter, will be presented and 
discussed by Glenn C. Blome, M.D., of Ottumwa. 
Fred L. Nelson, M.D., of Ottumwa will present and 
discuss a movie on Prostatic Hypertrophy. The 
meeting Tuesday, January 16, will be held at Hotel 
Ottumwa, with dinner at 6:30 p. m. The guest 
speaker of the evening will be C. Anderson Aldrich, 
M.D., of Rochester, Minnesota. 


Woridbury County 

The Woodbury County Medical Society held a spe- 
cial dinner meeting at the Mayfair Hotel in Sioux 
City Thursday evening, December 14, at'6:30 o’clock. 
The meeting was a testimonial in honor of Dr. Prince 
E. Sawyer who has been in practice in Sioux City 
for fifty years. Claude F. Dixon, M.D., of the Mayo 
Clinic was the guest speaker, and his topic was 
Remarks on Cancer and Its Curability. The Society 
had as its guests wives of the members and also 
members of the Sioux Valley Medical Society, which 
met in Sioux City earlier that day. 

Frank D. McCarthy, M.D., Secretary 


PERSONAL MENTION 

Dr. Lauren R. Moriarty has resumed his practice 
in Villisca after nearly four years of service in the 
Army Medical Corps, more than half of which was 
spent overseas. Dr. Moriarty, who served as a Cap- 
tain in the Army, has received a medical discharge. 


Lt. Col. Robert E. Mailliard of Storm Lake, who 
is with a medical unit of the fourth armored di- 
vision of the Third Army, has been awarded the 
bronze star medal for meritorious action in France, 
according to information recently received by his 
family. Colonel Mailliard went overseas a year ago, 
serving in England until last July when he was 
sent to France. 


Major Edward M. Honke of Sioux City, who re- 
ported for active duty in the Army Medical Corps 
in 1942, was recently awarded a Doctor of Science 
degree in urology by the University of Pennsyl- 
vania Graduate School of Medicine for work com- 
pleted while serving as Chief of the Urological 
Section at Torney General Hospital in Palm Springs, 
California. 


Dr. John P. Cogley of Council Bluffs, who entered 
the Army Medical Corps in May, 1942, and spent one 
year as chief of surgery in an evacuation hospital in 
New Guinea, has been placed on an inactive status 
because of physical disability incurred in service. 
Dr. Cogley, who held the rank of Lieutenant Colonel 
in the Army, plans to return in the near future to 
the Cogley Clinic for limited surgical and consultant 
practice. 


Dr. Ru.sl P. Noble has returned to Cherokee after 
receiving his retirement from the Army Medical 
Corps. Di'. Noble held the rank of Captain and 
served for many months in England as a flight sur- 
geon in the Air Corps. 


LI. Col. Leonard .1. Hospodar.sky, who practiced in 
Ridgeway before entering the Army Medical Corps, 
has been stationed in England for several months 
and has recently been accepted as a Fellow in the 
Royal Society of Medicine, according to information 
received by his family. 


MARRIAGE 

Miss Lois Hein, daughter of Mr. and Mrs. G. W. 
Hein of Davenport, and Dr. Arthur W. Shafer, son 
of Dr. and Mrs. Lee E. Shafer of Davenport, were 
united in marriage at a candlelight ceremony Fri- 
day evening, November 24, at 6:30 o’clock in Holy 
Cross Lutheran Church. Following a short wedding 
trip the couple will reside in Davenport at 2715 East 
Eighteenth Street. Dr. Shafer is engaged in the 
practice of medicine with his father. 


DEATH NOTICES 

Carpenter, William Sanford, of St. Louis, Mis- 
souri, aged seventy-three, died December 2 following 
an illness of six months. He was graduated in 1894 
from the University of Louisville School of Medi- 
cine, and at the time of his death was a life mem- 
ber of the Polk County and Iowa State Medical 
Societies. 


Gillespie, Hamilton S., of Sioux City, aged sixty- 
nine, died November 15 after a brief illness. He was 
graduated in 1898 from the University of Nebraska 
College of Medicine, and at the time of his death 
was a member of the Woodbury County and Iowa 
State Medical Societies. 


Link, Martha A. | McCullough, of Dubuque, aged 
fifty-nine, died December 1 following a long period 
of illness. She was graduated in 1909 from Milwau- 
kee Medical College, and at the time of her death 
was a member of the Dubuque County and Iowa 
State Medical Societies. 


Negus, Cora Weber, of Keswick, aged seventy-six, 
died November 14 following a heart attack. She 
was graduated in 1906 from the University of Iowa 
College of Medicine, and at the time of her death 
was a member of the Keokuk County and Iowa State 
Medical Societies. 


Smittle, Jacob Michael, of Waucoma, aged sixty- 
nine, died November 19 after an illness of several 
years. He was graduated in 1897 from the State 
University of Iowa College of Medicine and had been 
a member of the Fayette County and Iowa State 
Medical Societies. 


The JOURNAL 


Iowa State Medical Society 

VoL. XXXV Des Moines, Iowa, February, 1945 No. 2 


AIDS IN THE DIAGNOSIS OF PERIPH- 
ERAL NERVE INJURIES* 

Captain I. Joshua Speigel, M.C., A.U.S.J 

Stripped to fundamentals, the criteria for the 
evaluation of peripheral nerve injuries are rela- 
tively few and simple; so much so that in most 
cases the decision as to which nerve is at fault 
can he made in less than sixty seconds merely hy 
applying a few basic principles which are exceed- 
ingly easy to remember. ’ 

It is well known that complete interruption of 
any peripheral nerve results in : 

1. Loss of motor power of the muscles sujiplied 
by the nerve. 

2. Complete loss of sensation in the sensory 
distribution of the nerve. 

3. Atrophy of the muscles supplied by the in- 
voh'ed nerve. 

4. Trophic changes in the skin and its append- 
ages due to interruption of the sympathetic supply 
traveling along the preripheral nerve. 

5. Generally, the formation of a tender neuro- 
matous bull) on the proximal end of the cut nerve. 

6. Loss of the deep tendon reflexes in the ten- 
dons innervated. 

Partial interruption by injury of a peripheral 
nerve yields similar results to a greater or lesser 
degree. Also, it occasionally causes the production 
of severe pain of a burning nature, called caus- 
algia. 

In a fresh peripheral nerve injury there is, of 
course, no neuromatous bulb, no atrophy, and 
generally there has been insufficient time for 
trophic changes to develop. After a few weeks, 
however, these three phenomena are almost in- 
variably present. Erequently one can make the 
diagnosis (especially in the upper limb) by observ- 
ing the involved extremity and noting the atroph- 
ied muscle group and the portion of skin which 
shows trophic changes. 

*Presented before the Iowa State Medical Society, Wartime 
Meeting, Schick General Hospital, Clinton. August 11, 1944. 

tFrom the Neurosurgical Section of the Mayo General Hos- 
pital. Galesburg. Illinois. 


In general, then, the diagnosis can be made by 
observing the salient muscle weakness or paralysis, 
the area of anesthesia or hypalgesia, the muscle 
atrophy, and the areas of trophic change. As a 
valuable adjunct, the patient himself may be asked 
where his “hot spot” is and he will point to the 
skin or scar overlying the neuroma. When this 
scar is tapped gently, the patient experiences tin- 
gling sensations radiating to the areas receiving 
their sensory supply from it and thus, immediately, 
the involved nerve may be identified. The name 
Tinel’s sign is frequently given to this phenome- 
non, and it has mistakenly been said to indicate the 
presence of an intact or partially intact nerve. 
Actually it indicates merely that the proximal 
neuromatous bulb has been stimulated and is 
therefore yielding the only sensory response of 
which it is capable, namely, sensation in the area 
it originally subserved. (Tinel’s sign, however, 
has real significance after a nerve has been su- 
tured. Obviously the distal end of a severed nerve 
is not capable of sending impulses centrally. On 
the other hand, the proximal end when tapped will 
yield sensory impulses. If the Tinel’s sign be- 
comes obtainable further and further distally from 
the point of suture, it is irrefutable evidence that 
functioning nerve fibers are proceeding distally in 
the degenerated distal segment of nerve.) 

The anesthetic and hypalgesic areas will he de- 
scribed pedantically below. These areas are not 
always clearly delineated and, as is well known, 
the sensory areas shade into each other. It is 
presented thus in the interests of simplicity of de- 
tail and rapidity of diagnosis, because the mental 
picture of a characteristic sensory pattern is ex- 
ceedingly valuable. 

THE ULNAR NERVE 

I. Injury anywhere from the axilla to the upper 
third of the forearm, causes: 

(a) Paralysis of adduction and ulnar flexion 
of the wrist. 

(b) Paralysis of flexion of the distal phalanges 
of the ring and little fingers. 


38 


Journal oi- Towa State Medical Society 


February, 1945 


(c) Paralysis of abduction and adduction of all 
the fingers. 

(d) Paralysis of adduction of the thumb. 

(e) Weakness of flexion of the thumh. 

(f) Anesthesia or hypalgesia on the dorsal as- 
pect of the medial one-third of the hand, the lit- 
tle finger, and the medial side of the ring finger. 

(g) Anesthesia or hypalgesia on the volar as- 
pect of the palm of the hand. 

(h) Anesthesia or hypalgesia on the volar as- 
])ect of the little finger and the medial side of the 
ring finger. 

(i) Marked atrophy of the hypothenar emi- 
nence and of the interosseous spaces, especially the 
first interosseous space (between the thumb and 
index finger).. 

( j ) Atrophy of the ulnar side of the upper third 
of the forearm. 

(k) Moderate atrophy of the thenar eminence. 

II. Injury to the ulnar nerve in the middle third 
of the arm causes all the symptoms described in 
I with the exception of (a), (j), and frequently 
of (b) and (g). 

III. Injury to the ulnar nerve in the lower third 
of the forearm causes all the symptoms described 
in I with the exception of (a), (b), (g), (j), and 
frequently (f). 

IV. Injury to the ulnar nerve at the wrist causes 
all the symptoms described in I with the exception 
of (a), (b), (f), (g), and (j). 

V. Injury to the terminal deep branch of the 
ulnar nerve in the palm causes all the symptoms 
described in I with the exception of (a), (b), (f), 

(g), (h), and (j). 

median nerve 

I. Injury to the median nerve anywhere from 
the brachial plexus in the axilla to the upper third 
of the forearm causes : 

(a) Paralysis of radial flexion, and weakness 
of abduction of the wrist. 

(b) Paralysis of flexion of all the phalanges of 
the thumb and index finger. 

(c) Paralysis of pronation of the hand. 

(d) Marked weakness of flexion of the middle 
finger. 

(e) Mild weakness of flexion of the ring and 
little finger. 

(f) Anesthesia or hypalgesia on the volar as- 
pect of the thenar eminence and of the lateral two- 
thirds of the palm of the hand. 

(g) Anesthesia or hypalgesia on the volar as- 
pects of the thumb, index, middle, and radial half 
of the ring finger. 


(h) Anesthesia on the dor.sal aspect of the last 
plialanx of the thumh, index, middle, and radial 
lialf of the ring finger. 

(i) Paralysis of opponens action of the thumb. 

(j) Marked atrophy of the anterior surface of 
the upper forearm, especially on the radial side in 
the region of the bellies of the flexor tendons. 

(k) Marked atrophy of the thenar eminence. 

II. Injury to the median nerve in the middle 
third of the forearm causes all the symptoms men- 
tioned in I with the e.xception of (a), (c), (j), 
and partially of (b). 

III. Injury to the median nerve in the lower 
third of the forearm causes all the symptoms men- 
tioned in I with the exception of (a), (c), (e), 
(j ), and less of (b) . 

IV. Injury to the median nerve at the wrist 
causes all the symptoms mentioned in I with the 
exception of (a), (b), (c), (e), and (j). 

THE radial nerve 

I. Injury to the radial nerve anywhere from the 
axilla to the upper third of the arm eauses ; 

(a) Paralysis of extension of the elbow. 

(b) Slight weakness of flexion of the elbow 
(brachialis, brachioradialis) . 

(c) Atrophy of the posterior aspect of the arm 
(triceps) . 

(d) Anesthesia or hypalgesia over the dorsum 
of the arm and forearm. 

(e) Paralysis of supination of the forearm. 

(f) Paralysis of extension and abduction of the 
wrist. 

(g) Paralysis of extension of all the fingers and 
the thumb. 

(h) Paralysis of abduction of the thumb. 

(i) Marked atrophy of the dorsal aspect of the 
upper third of the forearm. 

(j) Anesthesia or hypalgesia over the lateral 
two-thirds of the dorsum of the hand, and the dor- 
sum of the first two phalanges of the thumb, index, 
middle, and radial half of the ring finger. 

II. Injury to the radial nerve in the middle 
of the arm causes all the symptoms mentioned in 
I with the exception of (a), (c), (d), and less 
of (b). 

III. Injuryto the radial nei've in the lower third 
of the area causes all the symptoms mentioned in 
I with the exception of (a), (b), (c), and (d). 

IV. Injury to the radial nerve at the elbow pre- 
sents a picture similar to III. At the front of the 
lateral epicondyle the radial nerve divides into its 
deep and superficial branches. 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


39 


V. Injury to the deep branch of the radial nerve 
in the upper third of the forearm causes all the 
symptoms mentioned in I with the exception of 

(a), (b), (c), (d), and (j). 

\"I. Injury to the deep branch of the radial 
nerve in the middle third of the forearm causes 
very few symptoms since at this level as the dor- 
sal interosseous nerve it has become the size of a 
fine thread. The accompanying- damage to ten- 
dons frequently causes a confusing wrist drop. 

VII. Injury to the superficial radial neiwe any- 
where in the forearm causes only anesthesia or 
hypalgesia as described in I (j). 

THE AXILLARY NERVE 

I. Injury of the axillary nerve causes: 

(a) Paralysis of abduction of the arm. 

(b) Anesthesia or hypalgesia over the lateral 
surface of the upper third of the arm. 

(c) Atrophy of the fleshy deltoid portion of 
the shoulder. 

THE MUSCULOCUTANEOUS NERVE 

I. Injury to the musculocutaneous nerve causes : 

(a) Almost complete paralysis of flexion of the 
elbow. 

(b) Anesthesia or hypalgesia over the lateral 
aspect of the forearm. 

(c) Atrophy of the front of the arm. 

In the upper extremity a few points should be 
borne in mind which make retognition of nerve 
injuries easy. It is easy to remember that the 
ulnar nerve innervates the little and medial half 
of the ring finger on the volar and dorsal surface. 
It is then equally easy to remember that the median 
nerve innervates the remainder of the hand on the 
\’olar surface, and the radial nerve innervates the 
remainder of the hand on the dorsal surface. 
Similarly, if one can remember that the radial 
nerve is dorsal, it follows that it supplies all the 
dorsal musculature, for example, extension ; 
whereas the median and ulnar nerves, being on 
the volar surface, supply flexion of the hand, each 
in general being limited to its own side except 
that the ulnar nerve is in the main responsible for 
the small muscles of the hand. 

With the entire arm, forearm, and hand in a 
cast, and with the thumb alone free, it is possible 
to make the proper diagnosis of nerve injury if 
such exists. 

(al If sensation is lost over the dorsum of the 
thumb and it cannot be extended or abducted, the 
radial nerve is involved. 

(b) If sensation is lost over the volar surface 
of the thumb and it cannot be flexed or opposed, 
the median nerve is involved. 


(c) If there is no loss of sensation and the 
thumb cannot be adducted, the ulnar nerve is in- 
volved. 

THE SCIATIC NERVE 

I. Total paralysis of the sciatic nerve is not 
frequently encountered. The injury generally in- 
volves only a portion of the nerve with resultant 
partial paralysis. Total paralysis can only occur 
with profound injuries in the upper third of the 
thigh or in the buttock and result in : 

(a) Paralysis of flexion of the knee (except 
for a slight action by the gracilis and sartorius 
muscles). 

(b) Paralysis of dorsi flexion of the ankle and 
toes. 

(c) Paralysis of plantar flexion of the ankle 
and toes. 

(d) Paralysis of inversion of the foot. 

(e) Paralysis of eversion of the foot. 

(f) Anesthesia over the outer surface of the 
leg, on the instep and sole of the foot, and over the 
dorsum of the toes, only the inner side of the 
leg and ankle escaping. 

(g) Atrophy of the posterior thigh and all the 
muscles of the leg and foot. 

II. Injury to the sciatic nerve in the middle third 
of the thigh, if complete, causes all the findings 
listed in I with the exception of (a). 

III. Injury to the sciatic nerve in the lower 
third of the thigh, if it involves both divisions, 
produces a picture similar to II. 

COMMON PERONEAL NERVE 

I. The lateral division of the sciatic nerve if 
injured anywhere from the popliteal space to the 
head of the fibula causes : 

(a) Paralysis of dorsi flexion of the ankles and 
toes with foot drop. 

(b) Paralysis of eversion of the foot. 

(c) Anesthesia or hypalgesia of the lateral as- 
pect of the leg and the dorsum of the foot and 
toes. 

(d) Atrophy of the anterior tibial and peroneal 
musculature. 

In the upper third of the leg the common 
peroneal nerve divides into the deep and super- 
ficial peroneal nerves. 

THE SUPERFICIAL PERONEAL NERVE 

I. Injury tO' this nerve in the upper third of the 
thigh causes a picture similar to paralysis of the 
common peroneal nerve with the exception of : 


40 


Journal of Iowa State Medical Society 


February, 1945 


(a) 'Fliere is paralysis of eversion of the foot, 
but (lorsi flexion of the foot is still present. 

(b) I'hc anesthesia or hypalgesia is limited to 
the lower third of the lateral aspect of the leg, and 
to the dorsum of the foot sparing the adjoining 
sides of the great and adjacent toes. 

(c) Only the peroneal musculature is atrophied. 

THE DEEP peroneal NERVE 

T. Injury to the deep peroneal nerve in the up- 
per third of thigh causes a picture similar to paraly- 
sis of the common peroneal nerve with the excep- 
tion that : 

(a) There is paralysis of dorsi flexion of the 
foot, but eversion of the foot is still present. 

(b) Anesthesia or hypalgesia is limited to the 
adjoining sides of the great and adjacent toes. 

(c) Only the anterior tihial musculature is 
atrophied. 

II. Injury to either of these nerves in the middle 
third of the leg generally causes only a 20 to 30 
per cent impairment in muscular function but the 
loss of sensation is as described for the upper 
third. Injury to either of these nerves in the lower 
third of the leg causes little if any paralysis, but 
the loss of^ sensation is as described for the upper 
third. 

TIBIAL NERVE 

I. The medial division of the sciatic nerve when 
injured in the rp^per third of the leg causes : 

(a) Loss of plantar flexion of the foot and toes. 

(b) Loss of inversion of the foot. 

(c) Atrophy of the calf musculature. 

(d) Atrophy of the small muscles of the foot. 

(e) Anesthesia or hypalgesia over the sole (lat- 
eral five-sixths), lower third of leg posteriorly, 
and plantar surfaces of toes. 

II. When injury is in the middle third of the 
leg, the findings are as in I except that there is 
only about 40 to 50 per cent loss of plantar flex- 
ion and inversion. 

III. When injury is in the lower third of the 
leg, the findings are as in I with only slight paraly- 
sis of plantar flexion of the toes, no loss of inver- 
sion, and no atrophy of the calf. 

IV. Injury to the medial plantar division of the 
tibial nerve causes : 

(a) Weakness of plantar flexion of the toes. 

(b) Anesthesia or hypalgesia over the plantar 
surface of the medial and anterior two-thirds of 
the sole of the foot. 

V. Injury to the lateral plantar nerve causes : 


(a) Very little loss of flexion of the toes. 

(b) Anesthesia or hypalgesia over the lateral 
and anterior third of the sole of the foot. 

THE FEMORAL NERVE 

I. Injury to the femoral nerve in the upper 
third of the thigh causes : 

(a) Paralysis of extension of the knee. 

(b) Anesthesia or hypalgesia over the anterior 
and lateral aspects of the thighs. 

(c) Atrophy of the anterior thigh musculature. 

A few hints are of aid in diagnosing lower limb 

nerve injuries. It is easy to remember that the 
common peroneal nerve supplies the lateral side 
of the leg and the dorsum of the foot and toes 
with sensation, dorsi flexion, and eversion. By 
remembering that the deep peroneal nerve supplies 
only the great and adjoining toes (and is there- 
fore medial), one can remember that it supplies 
the anteromedial (dorsi flexor) muscles, whereas 
the superficial peroneal nerve innervates the re- 
mainder or lateral side of the foot and therefore 
tlie anterolateral (everting) musculature. The 
tibial nerve is the nerve serving the back of the 
leg and sole of the foot. It supplies sensation to 
these areas and is responsible for plantar flexion 
and inversion. 

Certain confusing elements in the diagnosis of 
peripheral nerve injuries must he mentioned. 
Ankylosis from long disuse, fibrous shortening of 
atrophic muscles, and cicatricial deformities fre- 
quently cloud the picture and they can be recog- 
nized only if one is alert to their symptoms. “Trick 
movements’’ must be guarded against. Patients 
can mask an opponens paralysis by clever adduc- 
tion of the thumb and vice versa. By fixing the 
extensors of the fingers and extending the wrist, 
pseudo flexion of the fingers may be attained. 
If a nerve is regaining function, however, the 
fact must be carefully explained to the patient and 
attempts made to eliminate it. Otherwise the re- 
turn of function to the involved musculature is 
jeopardized. Finally, one should also heed any 
symptoms of causalgia. Severe burning pain re- 
lieved by moist cool applications, paresthesias, and 
trophic changes herald the presence of this bitter 
complication of nerve injury. It is frequently in 
the area of distribution (roughly) of the involved 
nerve. Nothing retards the recovery of nerve 
function as much as the determined effort of the 
patient to protect the extremity from any move- 
ment which causes pain. It becomes evident, there- 
fore, that if causalgia exists vigorous efforts 
should be made to treat it specifically before at- 
tempting to treat the known nerve deficit. 


VoL. XXX\^ No. 2 


Journal of Iowa State Medical Society 


41 


CANCER CONTROL, A DOCTOR’S 
PROGRAM 

Edmund G. Zimmerer, M.D., Des IMoines* 

The increasing mass of cancer propaganda that 
reaches his desk, some of it promulgated by non- 
medical groups, makes the doctor increasingly 
conscious of the popular interest in cancer and 
its control. Tde notes the concern of governmental 
agencies and even professional societies in the 
establishment of tumor clinics and is aware of 
the endorsement given such acti\'ities by organized 
medicine. Perhaps he is invited to participate in 
the work of tumor clinics, at least to the extent of 
referring his patients. Me patiently endures the 
lay campaigns in which his name appears as spon- 
sor. He may even be asked to speak at cancer 
meetings, often under lay auspices, and he may 
occasionally be embarrassed at sharing the plat- 
form with a glih lay speaker whose eloquence 
seems to put his own knowledge of the subject 
to shame. No wonder he sometimes asks himself 
where this will lead. 

The need for state control of communicable 
disease has long been conceded. The official super-- 
vision of motherhood and of infancy, as in the 
EMIC program of the Children’s Bureau, and 
even of the child of school age is accepted with 
more or less reluctance. The treatment of the 
venereal diseases under public auspices is acknow- 
ledged as the best means of controlling their in- 
fectiousness and preventing their spread. But the 
entry of public health into a field which deals with 
a condition not proven infectious and definitely 
shown to be noncommunicable, in which the inci- 
dence has been little influenced by treatment, 
seems to portend a ruthless invasion by the state 
into the whole realm of medical practice from 
pediatrics to geriatrics. 

The program of cancer control was not origi- 
nated by public health authorities, governmental 
agencies, or any professional group, but has 
evolved from a popular demand. It did not arise 
because of any revolutionary discoveries in either 
the prophylaxis or treatment of cancer, or even 
of any definite knowledge as to its underlying 
causes. It is the outgrowth of fear caused hy the 
increasing incidence of cancer. When any con- 
dition rises in a quarter of a century from fifth 
to second place among the leading causes of <leath, 
it obviously becomes a matter of public concern. 

Congress, in the first bill in history to be spon- 
sored by the entire body of the United States 
Senate, took official cognizance of the popular sen- 
timent in 1937 when it appropriated funds for the 

♦Director, Division of Cancer Control, Iowa State Department 
of Health. 


National Cancer Institute. The American Society 
for the Control of Cancer, now known as the 
American Cancer Society, Inc., was organized in 
1901. At first it was a purely professional 
society whose memhership included many leading 
jdiysicians and pathologists. Later it enlisted in- 
terested laymen and more recently has extended 
its activities hy establishing a Eield Army which 
has undertaken a widespread program of lay 
education, always in cooperation with medical so- 
cieties. 

The first public health recognition of the cancer 
jiroblem was in 1925 when a lay group headed 
by a prominent Catholic clergyman succeeded in 
securing an appropriation from the General Court 
of Massachusetts for the care of cancer patients. 
Thanks to the farsightedness of Dr. George Bige- 
low. ]>art of these funds was used for the study 
of the preventive aspects of malignancy. Thus, 
Massachusetts became the first state to establish 
a program of cancer control. To date nine states 
have full time personnel engaged in this work, 
and all health departments are giving cancer con- 
trol more or less attention. 

Hence, we behold an almost ideal setup for the 
solution of any public health problem. We have 
a widespread public interest, with press, pulpit, 
school, and every avenue of education willing 
and ready to do its part, a government anxious 
to give such aid as it can, state health departments 
everywhere giving it more and more attention, 
countless researchers aided by public and private 
funds carrying on intensive study in cancer 
genesis. All these, money, legislation, and organ- 
ization, are helpless to accomplish anything with- 
out the willing cooperation and leadership of the 
doctors in the hospital, in the city, in the rural 
home, everywhere. 

Obviously a completely satisfactory control 
program must await at least the discovery of the 
cause of cancer or a more thorough understanding 
of its nature, if not a specific remedy or some 
practical prophylaxis. Physicians would be the 
first to recognize that we cannot wait till we know 
all aliout a disease to do something about it, that 
we must use available means and knowledge to 
the best of our ability. 

Early and accurate diagnosis and prompt and 
adequate treatment are the keynote of our present 
program of control. Early diagnosis implies that 
the patient comes early to the physician and that 
the physician be qualified to act without delay. 
To that end it must be universally recognized by 
the public that cancer begins as a local disease 
and that while it is in that stage it is generally 
curable. We must strive to make all people alert 
to the early signs of malignancy and prompt in 


42 


Journal of Towa State Medical Society 


Feliruary, 1945 


seeking competent medical aid. Here lay educa- 
tion is our most important available means. Such 
education must be neither technical nor detailed. 
It must be simple, easily understood, and above 
all, motivating. The facts about cancer must be 
disseminated in the school and home, in the 
family, and in social circles to be effective. Lay 
organization is of the greatest assistance in giving 
us an entree to the very people most in need of 
education. 

True, there are disadvantages to campaigns by 
unofficial and particularly lay organizations aside 
from their frequent lack of dignity, but their 
practical value has been amply demonstrated in 
the fight against tuberculosis, venereal disease, 
and infantile paralysis. Whether we like it or 
not, lay education in health matters seems best 
accomplished by campaigns, with ballyhoo, post- 
ers, buttons, exhibits, and distribution of litera- 
ture. Such programs can be better carried out 
under lay than professional auspices, but must 
be restrained and directed by ethical and expe- 
rienced leadership. 

The widespread interest and the alarm created 
by misrepresentation and ignorance of the truth 
about cancer offer a fertile field to the charlatan 
and the quack which can be combatted only by a 
unified and authoritative program of education. 
Education implies a general dissemination of 
knowledge based on accurate conclusions drawn 
from known facts. In cancer, as in other diseases, 
this involves statistical evaluation of a significant 
universe such as is more readily accessible to a 
public health department than any other agency. 

Constant research and new discoveries con- 
tribute ever changing views as to the nature of 
malignancy, which must be quickly and carefully 
sifted to prevent the too ready acceptance of 
promised cures and yet make prompt use of these 
means which have merit for the suffering public. 
Only a centralized authoritative body close to 
organized medicine, the research laboratory, the 
hospital, and the clinician, and one which enjoys 
the confidence of the physicians and the public 
alike, can coordinate the conflicting trends of 
thought to avoid inconsistency. Only such a 
body can control and direct lay activity in health 
matters and coordinate them to professional guid- 
ance. 

The function of the health department, then, 
continues to be that of correlator and liaison be- 
tween the public and the physician. Its objec- 
tives cannot be attained without the confidence 
and cooperation of all agencies concerned, and 
least of all without the good will and active 
support of the doctor. Indeed, “the doctor is an 
integral part of the plan of public health admin- 


istration just as the lawyer is ])art of his court”. ^ 

\\T cannot shut our ears to the cry of the 
iniblic that something be done about cancer, fl'he 
people have spoken and in a democracy “the 
people should have what they want, but they 
must be protected from exploitation, lliey should 
have a voice with their physicians in the admin- 
istration of their health programs.”’ They need 
and desire medical leadership, and nothing is 
gained but much is lost by our refusal to give it. 

In the program of cancer control the doctor is 
the key man. On his degree of suspicion, upon 
his ability to recognize precancerous or early le- 
sions, upon his recommendations depend not only 
the success of the program but, more important, 
the life or death of the individual. The first doc- 
tor seen by the cancer patient has more to do with 
the ultimate outcome of the case than the surgeon, 
radiologist, specialist, or clinic. Such responsi- 
bility imposes the obligation of being informed 
and competent or at least willing to .seek compe- 
tent consultation. 

Unfortunately, too many doctors still have an 
ingrained pessimism regarding cancer that is not 
justified by the facts, and which reacts to the 
detriment of their patients. Almost 40,000 five 
year cures of definitely authentic cases of malig- 
nancy in the archives of the American College 
of Surgeons attest the curability of some cancers. 
Optimism is an important corollary to cancer 
control. 

Delay in the treatment of cancer is dangerous. 
If the delay is due to the patient’s ignorance or 
fear, it is bad enough; but if it is due to the doc- 
tor’s carelessness or incompetence, it is practically 
criminal. The doctor’s attitude plays an important 
role. If he makes light of a lesion, the patient 
will not regard it seriously either, and if he is 
instructed to return for further examination at 
some indefinite time he will be apt to postpone 
or neglect action until it is too late. 

On a statistical basis it may be presumed that 
one in every 133 patients seen by a physician in 
Iowa is a cancer patient.- That more cases are 
not diagnosed may be due to the low degree of 
suspicion on the part of the physician or to his 
indifference to preventive medicine. If he is 
consulted for a cut finger or a sprained ankle, 
he does not bother to question his patient about 
the apparent leukoplakia on his lip. In this age 
of specialization, we are drifting from the bene- 
ficial habits of the old family doctor. Preventive 
medicine not only redounds to the patient’s ad- 
vantage but is remunerative as well. 

1. E. W. Rowe, Better Health, Nebraska State Department of 
Health. 

2. Luis I. Dublin, Metropolitan Life Insurance Company, Letter 
of November 7, 1943. 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


43 


Teniporization with lesions of skin cancer is 
a common cause of delay that can be attributed 
to doctors.^ Irregular uterine bleeding is too often 
charged to the menopause and the doctor is too 
reticent to make a speculum examination. Even 
more common is our ready acceptance of the pa- 
tient’s own diagnosis of piles and neglect to make 
a simple examination. In fact, most of our mis- 
takes are due not so much to our inability to 
recognize signs as to our failure to look for and 
find them. 

The educational program of the ’Field Army 
stresses the importance of periodic physical exam- 
inations, but unless such examinations are thor- 
ough they not only fail to discover early cancer 
and save life but serve to discourage the patient 
and discredit the whole program. A mere his- 
tory, taking of blood pressure, a casual ausculta- 
tion of the chest, and a urinalysis will not always 
reveal cancer or permit us to give the examinee 
a clean bill of health. 

The following points in the examination of 
an individual for cancer are suggested as being 
essential : 

Examination of the lips, tongue, cheeks, tonsils, 
and pharynx for persistent ulceration, especially in 
the presence of a history of hoarseness or persistent 
coughing. In the latter case, a roentgenogram of 
the chest may be needed. 

Examination of the skin, of the face, body, and 
extremities for scaliness, bleeding warts, black moles, 
and unhealed scars. 

Examination of every woman’s breasts for lumps 
or bleeding nipples. 

Examination of subcutaneous tissue for lumps on 
the arms, legs, or body. 

Investigation of any symptoms of persistent indi- 
gestion or difficulty in swallowing and palpation of 
the abdomen. 

Examination of lymphatic system for enlarged 
glands, especially in the neck, axilla, or groin. 

Examination of the uterus for enlargement, lac- 
eration, bleeding or new growths; bimanual exam- 
ination to determine condition of ovaries and tubes. 

Examination of rectum, always important even 
in the absence of symptoms. 

Examination of urine for blood. 

Examination of bones and a roentgenogram of 
any bone that is the seat of pain. 

Examination of blood. 

Careful examination and a roentgenogram if indi- 
cated when the history or physical findings point to 
abnormality in any other organ or tissue. 

Biopsy, while ordinarily not a difficult proced- 
ure. is one of utmost value in confirming the 
diagnosis but should not be rashly done. In 
general, it should be made on the advice of and 
in consultation with the pathologist. 

The diagnosis and treatment of cancer are 
always of grave importance — too grave most 
times to depend on the judgment of a single 
individual no matter how competent he may be. 
No matter what the physician’s professional qual- 


ifications, he cannot hope to recognize cancer in its 
every possible manifestation; and if he could, he 
would not be able to recommend appropriate treat- 
ment in er'ery case. Thus, “Cancer has ceased,” as 
Ewing says, “to be a one man job.” Tumor clinics 
divide responsibility, make for earlier, more ac- 
curate, and definite decisions in diagnosis and 
treatment, and encourage better training in both 
the recognition and therapy of cancer. Tumor 
clinics may be established by county medical so- 
cieties in cooperation with the State Department 
of Health. A subsequent article will deal with 
their organization, benefits and use. Thus far, 
four are active in Iowa. 

Reference to a tumor clinic does not exclude 
the patient’s own physician. On the contrary, it 
enhances his position. No patients are accepted 
unless referred by a physician. The personnel 
of the clinic is selected by the local medical so- 
ciety. The referring physician is invited to par- 
ticipate in the examination and discussion of the 
case. All reports and treatment recommendations 
are made to him and he alone determines whether 
they shall be carried out, and where and by whom. 

The minimum obligation of the individual phy- 
sician to the program of cancer control is that 
imposed by his professional responsibility and 
common humanity, to make himself competent. 
He must be suspicious of malignancy in every 
obscure case. He should be alert to the earliest, 
even precancerous manifestations of the disease. 
He should have available laboratory, x-ray, and 
other diagnostic facilities and be ready to seek 
competent consultation. And withal he should 
develop a reasonable optimism regarding the out- 
come of cancer therapy. 

As a group, the profession can contribute to 
the training of its members. Cancer therapy, 
despite the fact that we still do not know all 
about the disease, is not static. Amazing advances 
have been made in recent years, especially in 
cancer of the breast, uterus, mouth, and buccal 
cavity. The medical society should have an active 
cancer committee whose function it is to bring 
modern thought on the subject before the society 
by means of frequent papers, symposia, and the 
like. It might well consider the establishment 
and maintenance of a tumor clinic. One of the 
principal benefits of the clinic is its professional 
training. Doctors should be encouraged to attend 
its clinical sessions, and frequent clinicopathologic 
conferences should be held. 

The committee could develop higher standards 
of service in the community by urging more thor- 
ough examinations of potential malignancies, em- 
phasizing the important steps in a complete phys- 


3. Connecticut State Department of Health. 


44 


Journal of Iowa State Medical Society 


February, 1945 


ical examination, jjointing' out the value and 
dangers of bioi)sy, securiiig l)eUer records so tliat 
treatment metliods can be better evaluated. A 
precise history and definite diagnosis are indica- 
tive of the ([uality of professional care the cancer 
patient is receiving. The same committee might 
well check on unorthodox treatment or unauthor- 
ized practice in the community. 

If the doctors or the medical society desire to 
extend their activities beyond the range of purely 
professional interest, they might properly consider 
the arranging of lay meetings for the extension 
of health education to the public and cooperation 
with interested agencies. Professional activity 
is lagging far behind public interest in cancer. 
Apathy, jealousy, or personal prejudice must not 
blind us to the prevailing trends in preventive 
medicine. The doctor’s place in this as in every 
program to fight disease and promote health is 
in the forefront. His leadership is desired and 
welcomed. The public and the state recognize 
their dependence on the doctor ; without him there 
can be no effective progress in any public health 
activity. 

The program of cancer control, borne of need 
and of fear, is no exception. The program is 
not state medicine. It is not a lay project. It 
is and must be and always shall be a doctor’s 
program. 


PSITTACOSIS IN IOWA 

REPORT OF A CASE 

First Lieutenant J. Howard Laubscher, 
M.C., A.U.S., 

Albert J. Wentzien, M.D., Tama, and 
Carl F. Jordan, M.D.^ Des Moines 

In reporting this, the first case of psittacosis to 
be notified to the Iowa State Department of 
Health, the authors wish to direct attention to 
psittacosis as an etiologic factor to be considered 
in cases of atyi)ical pneumonia. 

In a comprehensive article, Meyer’- describes 
the pandemic of psittacosis in 1929-1930 involving 
nearly 800 cases of human illness in the United 
States, England, and various countries in Europe, 
Scandinavia, and North Africa. The focus of in- 
fection was Argentina, the virus having been con- 
veyed there with shipment of 5,000 Psittacine birds 
from Brazil. 

The authors wish to thank K. F. Meyer, M.D., Director, Medical 
Center, George Williams Hooper Foundation, San Francisco, Cali- 
fornia, for cooperation in performing complement fixation tests 
and in demonstrating the virus of psittacosis; also B. J. Olson, 
M.D., Surgeon, United States Public Health Service, for assistance 
w^ith field investigation. 


Meyer states that the term psittacosis “is ]>ri- 
marily used to designate a ])eculiar contagious dis- 
ease of man, which may follow either fleeting or 
])rolonge<l exj)osure in a room, house. ]jet store or 
aviary where visibly diseased or a])parently healthy 
parrots, parrakeets, canaries and pigeons are held 
in cajjtivity. Since late in 1929 and in no way 
connected with the pandemic era (of 1929-1930), 
a total of 273 cases of psittacosis with 47 or 17 
per cent deaths have been clinically recognized in 
the LTnited States ami Canada.” 

Armstrong, McCoy, and Branham- emulsified 
the liver, heart, and other tissues of infected par- 
rots and parrakeets and filtered the emulsion 
through a Berkefeld N filter ; the sterile filtrate 
contained a filter-passing agent which caused dis- 
ease and death when inoculated into other birds. 
LevinthaP- descrilied minute, coccoid bodies in 
the form of diplococci or clusters, which he dem- 
onstrated in endothelial cells and in stained 
films of pericardial fluid ; he regarded the coccoid 
bodies as the causative agent of psittacosis. These 
bodies, jmobably more nearly related to bacteria 
than to true viruses, are known as Levinthal-Cole- 
Lillie bodies (LCL bodies), or Microbacterium 
multiforme psittacosis (MMP bodies). 

CASE REPORT 

History: A boy (J. H.), fifteen years of age, 
resident of Tama County, Iowa, was admitted to 
the University Hospital in Iowa City on June 22, 
1944, with the complaint of a cough of nearly two 
weeks’ duration. On June 17 gastro-intestinal 
signs appeared, marked by nausea and diarrhea. 
The day before admission he had a temperature 
of 104 degrees. It was the latter complaint that 
precipitated hospitalization, for he had continued 
to work while being troubled with the cough. 

This boy had been seen at intervals at the Uni- 
versity Hospital since 1942 for diabetes mellitus. 
This condition had been well controlled as evi- 
denced by records he kept and by his growth. With 
the onset of the present illness the insulin require- 
ment began rising, although he remained as active 
as before; after recovery, it receded just as rapidly 
as it had risen. 

The patient had been working at a place where a 
parrot was kept and among his duties was the fre- 
quent task of cleaning the parrot’s cage. On May 
29^’he parrot bit him on the hand. The injury was 
severe enough that it broke the skin and the boy 
sought medical attention. On June 10, 1944, ap- 
proximately twelve days after exposure to the par- 
rot, he began to cough. This cough was nonpro- 
ductive and not severe. The patient continued his 
usual activities until June 17 when he had abdom- 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


45 


inal pain and three to four watery stools each day 
for two days. These symptoms caused him to go 
to bed. He felt tired and his appetite decreased 
markedly. General malaise and headache were 
present for four days preceding admission. His 
temperature had been normal for these four days 
until the night before admission, when it rose to 
104 degrees. 

Hie attending physician (A.J.W.) reported that 
at the time of admission the patient’s pulse rate 
was only 80 per minute, a bradycardia contrasted 
with the high fever, and he seemed to have no 
respiratory distress. The possibility of psittacosis 
was recognized and the boy was sent to the hos- 
pital. 

Physical Examination: On admission, June 21, 
1944, the temperature rectally was 100 degrees. 
The patient weighed 113j^ pounds and his height 
was 65 inches. The height and weight were suffi- 
cient to prove that physical development had not 
been retarded by diabetes. The hoy did not appear 
acutely or chronically ill, but a persistent, hacking, 
nonproductive cough was noted. Physical exami- 
nation revealed a tender, swollen node in the right 
anterior cervical chain. The mucous membranes 
of the throat were mildly injected. There was 
a scar between the thumb and the first finger of 
the right hand where the parrot had bitten him. 
No evidence was present of infection at the site 
of the bite. There were no abnormal conditions 
observed in the remainder of the examination. 

Laboratory Findings: The white blood count 
was 5,900 cells and the hemoglobin 12 grams. 
The differential count made evident a slight pre- 
dominance of lymphocytes. Fifty-two lymphocytes 
were present of 100 cells counted. The remain- 
der of the cells were 8 band polymorphonuclears, 
34 segmented polymorphonuclears, 2 eosinophils, 
and 4 monocytes. The Wassermann reaction was 
negative and serologic studies for typhoid and un- 
dulant fever were also reported negative. Urine 
contained four plus reducing substance hut there 
were no acetone bodies or other abnormalities. 
The admission roentgenogram of the chest showed 
evidence of a small patch of pneumonitis in the 
lower lobe of the left lung. A repeat roentgeno- 
gram on July 5, 1944, gave evidence of a healthy 
chest. Blood was drawn and the serum sent to 
Dr. K. F. Meyer at the Hooper Foundation. The 
complement fixation test was reported positive in 
a titer of 1 :256. The positive laboratory report, 
together with the clinical findings and history of 
parrot exposure, confirmed the diagnosis of psit- 
tacosis. 

During the hospital stay the patient had no ele- 


vation of temperature; his cough subsided about 
ten days after admission. 

FURTHER DATA AND COMMENT 

A number of adults and two small children oc- 
cupy the residence in which the suspected parrot 
was kept. There were in addition several extra- 
household contacts, including the patient (J. H.) 
who was employed there much of the time pre- 
ceding his acute illness. Although other persons 
in the immediate environment may have been ex- 
posed, there was no definite history of pulmonary 
infection like that of the case reported. Serum 
specimens from four adult household contacts 
were sent to Dr. Meyer with recpiest for comple- 
ment fixation tests. Results of these tests are 
as follows : 

Complement Fixation Tests With Psittacosis Antigens on Serum 
of Household Contacts 


Complement Fixation Test 
Contacts Dilution 

1:2 1:4 1:8 1:16 1:32 1:64 

E.M 4-t- 2-f- 

C.M 4+ 3 + 

C.L i+ 2+ l-h 

B.M 4 + 


Complement fixation reactions in low dilutions 
are of little value; they may or may not be spe- 
cific or a manifestation of siibclinical infection. 

On the night of July 14, 1944, the parrot in- 
criminated in this case of psittacosis was shipped 
with dry ice, air express, to the Flooper Founda- 
tion. Although the bird had been destroyed and 
buried about twenty-four hours before it could 
be secured for shipment, the specimen arrived in 
satisfactory condition. 

Autopsy, as reported by Dr. Meyer on August 
12, “revealed a spleen 14x18 mm. which might be 
considered suspicious for latent psittacosis. The 
wash water of the heart blood failed to give a 
positive complement fixation reaction. To date 
the mice inoculated with the triturated spleen, liver 
and kidneys have shown no illness. However, 
several blind passages will be made before a final 
verdict will be rendered.’’ On September 3, a 
report from the California laboratory stated that 
the organs of this parrot were found through ani- 
mal passage to be positive for psittacosis. 

The length of time the parrot might have been 
infected before causing human illness is uncertain. 
The bird had lieen in the same home in Tama 
County for sixteen years, having been brought back 
from Florida. Could the parrot have been a virus 
carrier all these years? It appears likely that 
the bird might have acquired infection more re- 
cently through exposure to parrakeets. One of a 
pair of love birds died in this house about a year 
ago. Another love bird, cage-mate of the surviv- 
ing parrakeet, was forwarded to the laboratory to 


46 


Journal ok Iowa State Medical Society 


February, 1945 


lie tested for eAudence of virus. This bird was 
apparently free from infection, as evidenced by 
mice which were anatomically negative twenty- 
four days after inoculation with the parrakeet’s 
tissues. 

SUMMARY 

1 . Report is made of the first case of psittacosis 
to he diagnosed and notified in Iowa. 

2. Diagnosis was based on: (a) history of ex- 
posure to a parrot; (h) clinical and roentgeno- 
logic findings of atypical pneumonia: (c) positive 
complement fixation test for psittacosis on pa- 
tient’s serum: and (d) isolation of the virus of 
psittacosis from organs of the parrot. 

REFERENCES 

1. Meyer. K. F. : Ecology of psittacosis and ornithosis (De La- 
mar lecture). Medicine, xxi :175-206 (May) 1942. 

2. Armstrong, Charles ; McCoy, G. W. ; and Branham, Sarah E. : 
Filterability of infective agent of psittacosis in birds. Pub. Health 
Rep., xlv;725-726 (April 4) 1930. 

3. Levinthal, Walter: Die Atiologie der Psittakosis. Klin. 

Wchnschr., ix:654 (April 5) 1930; also Med. Welt iv:588 (April 
26) 1930. 

4. Levinthal, Walter : Recent observations on psittacosis. Lan- 

cet. i:1207-1210 (May 2.5) 1935. 


CANCELLATION OF MIDWEST CONFERENCE 
ON REHABILITATION 

At the request of the War Committee on Conven- 
tions, Washington, D. C., the Institute of Medicine 
of Chicago has cancelled its Midwest Conference on 
Rehabilitation scheduled for Monday, February 12, 
at the Drake Hotel in Chicago. 


CANCELLATION OF NATIONAL CONFERENCE 
ON MEDICAL SERVICE 

In compliance with a request received from the 
Office of Defense Transportation, the nineteenth an- 
nual session of the National Conference on Medical 
Service, scheduled for Sunday, February 11, at the 
Palmer House in Chicago, will not be held. 


AMERICAN COLLEGE OF SURGEONS DEFERS 
WAR SESSIONS 

The American College of Surgeons has deferred 
for the time being its 1945 series of War Sessions, 
four of which were to have been held in February, 
according to an announcement by Dr. Irvin Abell, 
Chairman of the Board of Regents. Dr. Abell states 
that plans had been completed for the February 
meetings because earlier indications were that ses- 
sions of a strictly educational nature, limited to 
relatively small local areas, would be sanctioned by 
the War Committee on Conventions, but it now devel- 
ops that the transportation crisis is so acute that 
even this type of meeting should be omitted in order 
to help the war effort, and the College is glad to 
cooperate with the agencies responsible for the move- 
ment of military personnel and supplies. 


BLUE CROSS IN IOWA 

Hospital Service, Inc., of Iowa, the local Blue Cross 
Plan, celebrated its fifth anniversary last month with 
over 200,000 members, according to F. P. G. Latt- 
ner. Executive Director. Fifteen Iowa hospitals 
signed contracts for this service prior to ,Ian- 
uary 1, 1940, when the first enrollment was started. 
Now seventy hospitals in this territory are extending 
this community service to employed persons and fam- 
ilies in their respective areas. 

Blue Cross has been referred to as one of the fast- 
est moving programs in the country. Mr. Lattner 
states that 50,618 persons in Des Moines, or about 
31 per cent of the population, are members. Up to 
last year the local plan confined the major portion 
of time on cities and towns, with the results that 
most of the larger cities of the state have from 25 
to 50 per cent of the population covered. 

Maternity care is the most exnensive service 
given. The waiting period has been reduced to nine 
months and nursery care of the baby is now included 
while the mother is in the hospital. Hospital Serv- 
ice, Inc., of Iowa points with pride to its 3,669 pre- 
paid Blue Cross babies up to the end of 1944. 

The local Plan has increased benefits five times in 
four and one-half years and is one of the few Blue 
Cross Plans which extend the same benefits to its 
members in over 3,000 member hospitals of the other 
eighty-two plans located in the United States and 
Canada. Non-member benefits are available in any 
hospital in the whole world. The local plan is also 
one of eleven midwestern and southwestern plans 
that have agreed on 100 per cent reciprocal agree- 
ments on transfers of members from one territory to 
the other. 

A rural enrollment program was started last, year, 
giving the farmers and rural residents in towns of 
2,500 or less the same privileges as the business, civic 
and industrial groups in the cities have had. Over 
10,000 persons have Blue Cross through the County 
Health Improvement Associations, which are spon- 
sored by the Farm Bureaus. These Associations 
make it possible for farmers to have the advantages 
of group enrollment. Ten counties have completed 
their first enrollment since the middle of last year, 
and many others are making plans to offer the pro- 
tection early this year. 

F. P. G. Lattner, Executive Director of the Plan, 
states that $1,522,133.47 has been paid for hospital 
care of members since the company was formed. 
Officers and members of the Board of Directors are: 
R. D. Bernard, M.D., Clarion; James D. Brien, Des 
Moines; Charles Bryant, Des Moines; O. R. Christof- 
ferson, Moline, Illinois; George^M. Crabb, M.D., Ma- 
son City; Mai’y L. Elder, Burlington; Paul Millhone, 
Clarinda; C. A. Mangelsdorf, Rock Island, Illinois; 
Carl G. Mullgrew, Dubuque; Paul G. Norris, Jr., 
Marshalltown; Martin I. Olsen, M.D., Des Moines; 
A. 0. Lothringer, Davenport; Joseph Rosenfield, Des 
Moines; and J. P. VanHorn, Cedar Rapids. Mr. 
Rosenfield is President, Dr. Olsen, Vice President, 
and Mr. Brien, Secretary and Treasurer. 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


47 



DIPHTHERIA IN 1944 

Reported cases of diphtheria during the past 
year numbered 203. The solid line in the accom- 
panying line diagram' shows the number of cases 
as reported by months in 1944. The broken line 
represents the nine-year average of month-by- 
month reports for the period 1935-1943 ; it serves 
as a basis of what to expect during the months of 
a current year. It will be noted that the preva- 
lence of diphtheria was below average during eight 
of the first ten months of last year. A sharp rise 
in reported incidence developed in November with 
39 cases and continued through December. In 
January, 1945 (through January 19), reported 
cases were 14, the expected number for the entire 
month being 28. 



JyMAM JJASOND 
Month of Report 

DIPHTHERIA IN IOWA— 1944 

Reported Prevalence by Months, Compared With the 9-Year 
Average for the Period 1935-1943. 


POLIOMYELITIS DURING 1944 

Although not a case of poliomyelitis was notified 
to the State Department of Health during the first 
six months of 1944, the disease developed above- 
expected prevalence in July and the year closed 
with a total of 204 reported cases. The accom- 
panying histogram (solid line) portrays the undue 
incidence of poliomyelitis during the past season ; 
the dotted line shows the expected level for each 
month, based on the reported morbidity experience 
of the past nine years (1935-1943). 


76 

70 

66 

60 

66 

50 


46 

u 

< 40 

i 

^ 30 
26 
20 
15 


10 


6 


JPUAMUJASO ND 
MONTHS 

POLIOMYELITIS IN IOWA— 1944 
Showing Reported Incidence by Months Compared With the 
9-Year Average for the Period 1935-1943. 


TRICHINIASIS OUTBREAK IN CEDAR COUNTY 

The reporting of over 80 cases of trichiniasis 
(trichinosis) from Lowden and vicinity during 
the second and third weeks of January, 1945, 
constitutes the largest outbreak of this disease to 














































19 

M 































































































— 























— 



















19 

>6-194 

; 







— 


48 


Journal of Iowa State Medical Society 


February, 1945 


l)c notilied to the State Department of Health 
during the past sixteen years. Report of the first 
cases was made hy Fred Montz, M.D., local health 
officer of Lowden in Cedar County. 

NATURE OF ILLNESS 

Early complaints on the part of patients were of 
‘‘stomach cramps” and diarrhea, the latter varying 
from a day in mild cases to a week or longer in 
persons more seriously ill. Other symptoms and 
signs included fever, sweating, headache, muscle 
and joint pains, urticaria, and swelling and edema 
of the face, jiarticularly of the eyelids. Many of 
the patients had symptoms of onset between 
Christmas and New Year’s or during the early 
part of January. 

AGE. AND SEX OF VICTIMS 

Adults and middle-aged persons, male and fe- 
male, as well as children, had illness and com- 
plaints as above mentioned. In some families all 
members of the household were sick. If anyone 
escaped illness, such a person had not partaken of 
the meat suspected of having caused infection. 

CLINICAL DIAGNOSIS CONFIRMED BY LABORATORY 
TESTS 

The clinical diagnosis of trichiniasis was con- 
firmed by the finding of a high percentage of eosi- 
nophilia in blood films. Eosinophils comprised 
from 35 to 44 per cent of the white blood cells in 
differential counts as reported by I. H. Sorts, 
M.D., Director, State Hygienic Laboratory. 

TRICHINA LARVAE FOUND IN SAUSAGE 

All of the patients had eaten one or more slices 
of smoked pork sausage known as “Mettwurst,” 
made and purchased at a local meat market. Por- 
tions of several dififerent sausages collected from 
homes in which illness occurred were examined at 
the State Hygienic Laboratory and by L. O. Nolf, 
Ph.D., of the Department of Zoology at the Uni- 
versity of Iowa. Larvae of Trichinella spiralis, 
representing mild to moderately severe infestation, 
were found in the specimens of pork sausage. 

POSSIBLE SOURCES OF INFESTATION 

The sausage was made early in December, 
smoked for a period of about ten days and then 
sold during the following days. The hogs from 
which several lots of smoked sausage were made 
came from farms near Lowden. Field investiga- 
tion and inquiry revealed that garbage had not 
been fed to hogs on these farms. However, rats 
were found to be present in large numbers. Lab- 
oratory work is being continued to determine 


whether or not rats probably played an important 
part in the spread of Trichina infestation. 


JAUNDICE OUTBREAK STUDIED 

During the second week of January, 1945, a 
field study of an epidemic of infectious hepatitis 
(acute catarrhal jaundice) in Tama County, was 
conducted by the United States Public Health 
Service, in cooperation with attending physicians 
and the Iowa State Department of Health. Report 
of the first cases of jaundice was made by A. J. 
Wentzien, M.D., Local Health Officer, Tama, 
Iowa. 

Investigation of approximately 100 cases of 
infectious hepatitis was made by Surgeon Dorland 
J. Davis, M.D. Arrangement for Dr. Davis’s 
visit to Iowa was made by Charles Armstrong, 
AI.D., Senior Surgeon, Division of Infectious Dis- 
eases, U. S. Pulilic Health Service. 

The study included securing of throat washings 
and blood specimens of a number of the patients 
in the early stage of illness ; specimens for labora- 
tory examination were forwarded to the National 
Institute of Health, Bethesda, Maryland. 

General information with reference to infec- 
tious hepatitis (acute catarrhal jaundice) is con- 
tained in the Department’s Rules and Regulations, 
pages 87-88. “There is considerable variation in 
the degree of severity of the disease, ranging from 
anicteric cases to cases of acute yellow atrophy of 
the liver. A similar clinical picture has been ob- 
served following certain industrial intoxications, 
anti-syphilitic treatment, and several immunization 
procedures, but the relation of these clinical con- 
ditions to infectious hepatitis has not been deter- 
mined.” 


PREVALENCE OF DISEASE 

Most Cases 


Disease Dec., ’44 

Nov., ’44 

Dec., 

’43 Reported From 

Diphtheria 

. . 28 

39 

7 

Woodbury, Clin’ton, 
Muscatine 

Scarlet Fever . . . 

. .220 

224 

552 

Polk, Linn 

Typhoid Fever . . . 

. . 0 

4 

2 


Smallpox 

. . 0 

1 

4 


Measles 

. . 75 

40 

242 

Guthrie, Woodbury 

Whooping Cough. 

. . 25 

17 

97 

Dubuque, Des Moines 

Brucellosis 

. . 13 

35 

35 

Appanoose, Dubuque 

Chickenpox 

. .216 

240 

520 

Woodbury, Dubuque, 
Mahaska 

German Measles.. 

2 

2 

71 

Johnson 

Influenza 

, . 0 

1 

22,659 


Malaria 

Meningococcus 

. . 10 

75 

0 

Page 

Meningitis .... 

. . 7 

3 

12 

Wapello 

Mumps 

. .127 

121 

65 

Johnson, Dubuque, 
Black Hawk 

Pneumonia 

. . 32 

32 

129 

Black Hawk, Marshall 

Poliomyelitis .... 

. . 6 

14 

2 

Carroll, Jones 

Tuberculosis .... 

. . 49 

39 

54 

For the State 

Gonorrhea 

. .171 

244 

122 

For the State 

Syphilis 

. .122 

163 

184 

For the State 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


49 



ISSUED MONTHLY 


Lee Forrest Hill, Editor Des Moines 

Dennis H. Kelly, Associate Editor Des Moines 

PUBLICATION COMMITTEE 

Lee Forrest Hill, Editor Des Moines 

Dennis H. Kelly, Associate Editor Des Moines 

Robert L. Parker, Secretary Des Moines 

Oliver J. Fay. Trustee Des Moines 

John I. Marker. Trustee Davenport 

Walter A. Sternberg, Trustee Mount Pleasant 


SUBSCRIPTION $3.00 PER YEAR 


Address all communications to the Editor of the Journal, 
SO 5 Bankers Trust Building, Des Moines g 

Office op Publication, Des Moines 9, Iowa 


Vol. XXXV FEBRUARY, 194,5 No. 2 


AMERICAN MEDICAL ASSOCIATION NOT 
WITHOUT PROGRAM 

Criticism of the American Medical Association 
is not infrequently heard from various sources to 
the effect that it has failed to advance a program 
for tlie extension of medical care in keeping with 
the changing needs of the times and that it insists 
u]xin the preservation of the “status quo,” so far 
as the practice of medicine is concerned, of a 
quarter century ago. 

That this is not a just criticism is clearly indi- 
cated by two statements approved and released on 
December 6, 1944, by the Council on Medical 
Service and Public Relations of the American 
Medical Association, These statements should be 
studied carefully by every member of tbe medical 
profession so that they may inform the public of 
medicine’s proposals for extension of medical care. 

Dr. Louis H. Bauer, member of the Board of 
Trustees and member of the Council, summarizes 
the revised platform of the American Medical 
Association adopted by tbe House of Delegates in 
June 1944 as follows; 

1. Continued expansion of the practice of medicine 
with full development of approved voluntary hos- 
pital, medical, indemnity, industrial and commercial 
insurance against the costs of medical care. 

2. Development of public health facilities for pre- 
ventive medicine all over the country. 

3. Development of adequate diagnostic facilities 
everywhere. 

4. The use of the voluntary insurance principle in 
caring for the indigent and medically indigent. 

5. The development of hospital facilities where 
present facilities are used to the utmost and are still 
inadequate. 

6. The use of federal funds to aid communities in 
public health measures, care of the indigent and con- 
struction of necessary hospitals, when local commu- 
nities are unable to finance the projects, but with 
retention of local administration. 


7. The creation of a unified Federal Department 
of Health. 

He further states, “This platform is the basis 
of a more widespread distribution of medical care 
in a manner that will solve tbe financial problems 
of illness which confront many ]>eople. 

“Economically, there are four groups of people 
in the United States : ( 1 ) those who are financially 
well enough off to meet any situations which they 
may face: (2) those who can meet the ordinary 
costs of living and ordinary medical expenses, 
but who find it difficitlt to meet the costs of long 
and expensive illnesses: (3) those who can meet 
the costs of the bare necessities of life, but who 
cannot meet the costs of any sickness ; and (4) the 
class which is dependent upon public aid for hous- 
ing, clothing and nutrition, as well as medical 
care.” 

Groups two and three are those which par- 
ticularly need help, says Dr. Bauer. Those in 
the first group can take care of themselves, and 
those in the fourth group are well provided for in 
most areas, but states, counties and towns should 
be urged to purchase voluntary insurance policies 
for their indigent and near indigent. Concerning 
•voluntary insurance plans — the method proposed 
for meeting the needs of groups two and three — 
Dr. Bauer states, “In the development of any new 
type of insurance it takes time to make it success- 
ful and acceptable. Various voluntary non-profit 
medical indemnity and service plans have been 
developed and modified and are being increasingly 
well distributed over the country. Growth has 
been slow, but during the past year growth has 
been more rapid, and ideas as to the best type of 
plan are gradually crystallizing. There have been 
industrial plans existing in some cases for as long 
as 20 years, but there are many which have de- 
veloped during the past few' years. Commercial in- 
surance is becoming increasingly available. Group 
hospital insurance has grown rapidly. There 
are now' over 16,000,000 people covered by group 
hospital insurance; there are about 25,000,000 
covered, to at least some degree, by voluntary non- 
profit medical, industrial and commercial plans. 
These plans must be made available to everyone 
desiring coverage at a cost within his means to 
pay.” 

Dr. Bauer further states that “The Council feels 
that such plans, including group hospital insur- 
ance, can he made effective at a far less cost and 
w'ith more satisfactory service than any compul- 
sory government controlled plans.” He also indi- 
cates that the platform of the American Medical 
Association recognizes that there are too many 
counties or districts without adequate health 
supervision and it urges that every area be 


50 


Journal of Iowa State Miomcal Society 


February, 1945 


pro])crly covered. Federal fun<ls may be used 
for extendiiyc; ]>ublic liealth facilities and medical 
care of the indigent if the local community is un- 
able to do so, but the administration of the problem 
should be decentralized an<l local rather than 
federal. The needs of communities as to hospitals, 
diagnostic facilities, and practicing physicians 
must be met, but only after present facilities are 
used to the utmost. 

Dr. Bauer concludes that “the facts are that the 
public is demanding a method of prepaying its 
medical bills, particularly in the case of so-called 
catastrophic illness, and that it wants that method 
on a voluntary basis. It further desires that med- 
ical care to be of a high quality and readily avail- 
able.” 

The second statement is by Dr. John II. Fitz- 
gibbon, Chairman of the Council. Says Dr. Fitz- 
gibbon, “The objective of the medical profession 
of this country is the provision of good medical 
care to every person in the United States. The 
Council on Medical Service and Public Relations 
intends to promote this objective. Solution of 
the problem of providing medical care of good 
quality is not simple because of varying conditions 
in different communities, particularly economic 
and environmental conditions which, while not 
generally considered health problems, have a 
marked effect upon the health of persons con- 
cerned. Eradication of conditions contributing 
to poor health in a community requires joint action 
by the medical profession and other public spirited 
persons. 

“In providing good medical care to the entire 
nation three phases of the problem must be solved. 

“(1) Adequate trained professional personnel 
and facilities for providing preventive, diagnostic, 
and treatment services must be made available to 
all areas ; 

“(2) Sound economic arrangements for financ- 
ing these services and facilities must he set up; 
and 

“(3) Educational efforts will be required to 
inform the people of the value of good medical 
care in order to induce them to make intelligent 
use of the services and facilities made available.” 

Other planks in the platform of the American 
Medical Association stressed by Fitzgibbon are ; 

A. In the extension of medical services to all 
people, the utmost utilization of qualified medical 
and hospital facilities already established. 

B. The continued development of the private prac- 
tice of medicine, subject to such changes as may be 
necessary to maintain the quality of medical services 
and to increase their availability, including the de- 
velopment and extension of voluntary hospital in- 
surance and voluntary medical insurance. 

C. Expansion of public health and medical serv- 
ices consistent with the American system of de- 
mocracy. 


D. The allotment of such funds as the Congress 
may make available to any state in actual need for 
the prevention of disease, the promotion of health 
and the care of the sick on proof of such need. 

E. The principle that the care of the public health 
and the provision of medical service to the sick is 
primarily a local responsibility. 

F. The development of a mechanism for meeting 
the needs of expansion of preventive medical services 
with local determination of needs and local control of 
administration. 

G. The extension of medical care for the indigent 
and the medically indigent with local determination 
of needs and local control of administration. 

Here, then, are important statements from two 
outstanding and nationally recognized officials of 
the American Medical Association, which give in 
clear-cut fashion medicine’s proposals for meeting 
the medical needs of all our citizens. This is not 
a “status quo” platform; nor is it state medicine. 
But it is the American way of meeting problems. 
Let us all get behind our Association’s platform 
and strive to make it work ! 


STREPTOCOCCOSIS 

Every physician is fully aware of the important 
role played by the streptococcus in human disease, 
but to combine its various manifestations as ob- 
served in different age periods under a single 
heading, as we are accustomed to do in tubercu- 
losis, is perhaps a concept which has escaped many 
of us. 

Powers and Boisvert present this practical and 
instructive point of view in a paper published in 
the December 1944 issue of the Journal of Pedi- 
atrics under the title “Age in Streptococcosis.” 
The authors first stress the fact that age is an 
important modifying factor in the morbid proc- 
esses resulting from the same infecting agent. 
As an illustration they refer to tuberculosis with 
its well-known childhood, latent, and adult mani- 
festations. Infection produced by the hemolytic 
streptococcus. Group A, presents comparable 
variations in its clinical manifestations to tubercu- 
losis. Thus, under the over-all term of strepto- 
coccosis the clinical designations of childhood, 
intermediate, adult, and latent types are specified, 
and included are the various septic complications 
occurring at any age, plus hemorrhagic n.ephritis 
and rheumatism which are unusual in infants and 
young children. 

Streptococcal fever, childhood type, is the com- 
mon form of streptococcosis in children under 
three years of age. In infants under six months 
the disease is usuall}^ mild, manifests itself by a 
characteristic nasal discharge and is over in a pe- 
riod of five to six weeks, but children between six 
months and three years of age are more severely 
ill. The onset may be with symptoms of an acute 
nose and throat infection. Fever, high at first. 


VoL. XXXV, No. 2 


Journal of Iowa State. Mf.imcal Society 


51 


may last from six to eight weeks : cervical glands 
become involved; otitis media is frequent: anemia 
develops; appetite is poor; and the children are 
fretful and unhappy. Convalescence and return 
to health may he a matter of months. Bacteremia 
occurs not infrequently in this group and hemo- 
lytic streptococcus, Group A, is usually the pre- 
dominant organism to he recovered from the nose 
and throat. Sequelae such as hemorrhagic ne- 
phritis or rheumatic fever are rare, hut suppura- 
tir-e complications are frec|uent. Here, then, is the 
young child's reaction to his first infection with 
hemolytic streptococcus — a generalized, sub-acute, 
long drawn out process. This needs to be con- 
trasted with the older child’s or adult’s reaction 
(most of whom have had previous infections). 
In these patients the attack is focalized as in acute 
tonsillitis, is short and abrupt in its clinical course, 
and characteristic complications are peritonsillar 
abscesses, hemorrhagic nephritis, and perhaps 
rheumatic fever. 

The intermediate type of streptococcal fever, 
between the childhood type on the one hand and 
the adult type on the other, is scarlet fever oc- 
curring most frequently in persons between the 
ages of three and ten. The latent type of strepto- 
coccosis refers to individuals of any age who are 
carriers of hemolytic streptococci. 

In the ten year period from 1934 to 1944 there 
were admitted to the pediatric service of the New 
Haven Hospital 8,889 patients of whom 1,237 or 
14 per cent were diagnosed as having strepto- 
coccosis. Seven per cent of the admissions in the 
first year of life had streptococcosis, hut the 
highest proportions came in the sixth year with 
22 per cent; of these 38 per cent had scarlet fever. 
The authors go on to designate the number and 
age distribution of the various purulent strepto- 
coccal lesions commonly associated with strepto- 
coccal fevers. Thus otitis media, cervical adenitis, 
bacteremia, all had their greatest incidence in the 
first five years of life. Two-thirds of the cases of 
streptococcic empyema and 80 ]ier cent of the 
cases of streptococcic peritonitis occurred in 
children under seven years. On the other hand, 
of 143 cases of acute hemorrhagic nephritis only 
three patients were under two years of age and 
100 were lietween two and ten years of age. 
Statistics are also given for erysipelas, infected 
eczema, vaginitis, and so forth, hut the reader is 
referred to the original article for further infor- 
mation concerning these. 

• Our point will have been established if we have 
made it clear that the chain of events which fol- 
lows the successfid implantation of hemolytic 
streptococci in the respiratory tract of individuals 
follows a different pattern depending upon the 


age of the individual and tliat the whole chain of 
events can he designated under the term strepto- 
coccal fever. Particularly are we impressed with 
the usefulness of this term in giving a more in- 
clusive concept of a disease process in the first 
three years of life. 


CONGENITAL MALFORMATIONS ARISING 
FROM DEFICIENT MATERNAL DIET 

In a previous issue (December 1944) we called 
attention in these columns to certain congenital 
malformations (heart, cataract, microphthalmia, 
etc.) which had lieen observed in the offspring of 
women who had had German measles in the early 
months of pregnancy. 

Now another cause has been advanced for other 
types of congenital malformations. It should be 
stated, however, that thus far these observations 
have been made only in the experimental animal. 
Proof that a similar situation exists in the human 
remains to be demonstrated. Josef Warkany of 
the Children’s Hospital Research Foundation and 
the Department of Pediatrics at Cincinnati, Ohio, 
presented his experimental findings before the 
meeting of the American Academy of Pediatrics 
in St. Louis in November 1944, and his paper is 
published in the December 1944 issue of the Jour- 
nal of Pediatrics. 

In the rat congenital malformations could he 
regularly induced in the offspring when the ma- 
ternal diet was made deficient in vitamin A, in ribo- 
flavin, or in vitamin I). Malformations observed 
were different for each type of vitamin deficiency. 
Thus, if the diet of the maternal rat was deficient 
in carotene and vitamin A, such of the young as 
were born alive were blind and had deformed eyes. 
Addition of vitamin A to the maternal diet pre- 
vented these deformities. The point is empha- 
sized that such deformities are not genetic in origin 
hut are the result of arrest of development in an 
early embryonic stage. 

Another experimental group of rats was reared 
and bred on Steenhock and Block’s rachitogenic 
diet hut they were given vitamin D to prevent rick- 
ets. About one-third of the young showed deform- 
ities, largely skeletal, such as shortness of the 
mandible, radius, ulna, tibia, and fibula, fusion of 
the ribs, syndactylism of the fingers and toes, and 
cleft palate. Addition of liver to the maternal diet 
prevented the appearance of the deformities. A 
further search to find the responsible factor in 
liver proved it to he riboflavin. From histologic 
study of the rat embryo Warkany postulates that 
the malformations resulting from a riboflavin 
maternal diet deficiency are determined not be- 
fore the thirteenth and not after the fifteenth day 

(Continued on page 65) 


52 


Journal oi'- Iowa State Medical Society 


February, 1945 


ROMANCES OF CARDIOLOGY 

Daniel J. Glomset, M.D., Des Moines 
There were giants in the Land (Gen. 6:4) 


I like to think of man as living on the Island 
of the Known surrounded hy the vast Sea of the 
Unknown. This Island exists because of men’s 
curiosity, intelligence, and energy. At the dawn 
of history it was hut a tiny speck ; down through 
the ages it has gradually grown until today it is 
of continental size. So vast is knowledge that a 
single individual can master but a small part of it. 
The growth of the Island has not been steady. 
There have been periods when it rose 'rapidly out 
of the Ocean. There have been centuries when 
its coast line remained stationary. And there have 
been periods when parts of the Known have sunk 
back into that “Immortal Sea from whence it 
came.’’ 

Medical science forms a considerable part of 
the Island of the Known. A phase of this science 
deals with the anatomy, the physiology, and the 
diseases of the heart. This is called cardiology. 
I like to think of it as a Cape jutting out into the 
Ocean of the Unknown from the medical Peninsula 
of the Island of the Known. The Cape of Cardi- 
ology has been elevated from, and extended into 
the Sea of the Unknown by the sweat, blood, and 
tears of scientific giants in the earth. I should 
like to tell you about the development and growth 
of cardiology and give you my impressions of 
some of the giants whose sweat, blood, and tears 
raised it. 

Cardiology is a youth among the sciences. When 
the sixteenth century came to a close, it did not 
exist. To be sure, Hippocrates knew of the heart. 
He thought it the site of the soul, immune to dis- 
ease ; and Eristratus wrote about it as a muscular 
pump. Galen, who was born in 130 A. D., dis- 
covered by actual experiments that the arteries 
contained blood, and not vapor, as was believed 
prior to his day. But he then developed the most 
fantastic theories about the function of the heart 
and the blood. He held that the blood was formed 
in the liver, ebbed and flowed as two well bal- 
anced systems from the liver, through the heart, 
to the rest of the body. From the liver the blood 
moved to the right heart, thence by invisible pores 
through the ventricular septum to be purified by 
the spirit from the lungs in the left heart. After 
this it once more ebbed and flowed through the 
arteries to supply the body. Because of Galen’s 
many contributions to medicine, he was almost 
deified by the doctors, just as the bishops deified 


the person and the sayings of the Carpenter from 
Nazareth, and under the soporific influence of such 
deifications the dark ages set in. For thirteen 
centuries and more the writings of Galen became 
the holy writ of medicine, and woe to him who 
even dared to question the sacred sayings of the 
semi-god. The intellectual life died, darkness 
covered the earth, and there was no spirit of God 
brooding over it. 

The first reawakening of the human intellect 
occurred in the universities which were established 
in Europe in the thirteenth, fourteenth, and fif- 
teenth centuries. These were founded first in 
Italy, later in other parts of Christendom. It was 
in these institutions that truth-seeking men began 
to think and to enjoy the thoughts of others. It 
was here that the curse upon unseeing eyes and 
non-hearing ears was lifted. In the middle of 
the fifteenth century, two, yes, even three signifi- 
cant events took place : the invention of printing 
in Germany (1448) ; the destruction of the Byzan- 
tine Empire with the fall of Constantinople 
(1453) ; and the driving out from Mainz of the 
German master printers by the Duke of Nassau 
(1462). 

The Byzantine scholars, who had kept “the 
light which was Hellas’’ flickering during the 
dark centuries, were driven into exile by the Turks. 
They naturally traveled to congenial places and 
took the papyra of the old Greek writers with 
them. Large numbers of the Greek scholars set- 
tled in and around the Italian universities, and 
students of Padua, Florence, Bologna, and other 
universities began to search eagerly the “Greek 
Scriptures.’’ It became the vogue to read Greek 
manuscripts, to study them in the original, and 
to translate them intoYhe, language used by the 
students. The German printers, too, flocked to 
the university towns and began to print good 
translations of the original works of the great 
Greeks and to spread the books throughout the 
western world. Thus the Greek ferment spread to 
thinking men by the printed book, and caused 
rapid growth of the Island of the Known. The 
Renaissance was on ! Columbus and his sailors 
dared to sail west to fall off the edge of the 
world. Copernicus found that the earth and the 
other planets revolved around the sun. Luther 
defied the Pope and got by with it. Henry VIII 
also defied the Pope — to be sure from a less 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


53 


worthy motive ! He, too, got by with it ! And 
Leonardo de \nnci painted accurately what he 
saw, not according to his teachers’ precepts. 

Students from all over Europe flocked to the 
intellectually vigorous universities of Italy. 
Among them were a Flemish medical student, 
Andreas Vesalius, and a Greek student from 
England, John Cains. The two became fellow 
lodgers at Padua, then the queen of the arts. 
Vesalius knew his Galen, and Cains, an instructor 
in Greek, was evidentl}^ looking for more Galenic 
manuscripts to translate. One can imagine that 
the two talked a lot about Galen and that Vesalius 
invited his English friend to the anatomic labora- 
tory to show him how erroneous some of Galen’s 
theories were. Wsalius was at that time working 
hard on his Corporis Hmnani Fahrica, which he 
published at the age of twenty-eight. Vesalius had 
put the best he had into that book and naturally 
expected proper recognition from his colleagues. 
He did not get it. Then, as now, the deadheads 
covered their nakedness with a cloak of silence. 
Those who had publicly affirmed Galen heaped 
abuse on the young upstart from the provinces 
Y’ho had the nerve to state in print that the mighty 
Galen was often wrong. V esalius’s own teacher, 
Valsalva, led in heaping abuse on the man who 
by his labor had started the medical Renaissance. 
Vesalius got tears for his sweat. In a fit of anger 
he threw his manuscripts into the fire, left Padua 
and its pinheaded professors, and went to Spain 
to live in ease and peace as physician to Charles 
V. However, he had started a new era in medi- 
cine ! And although he must have thought he had 
labored in vain at Padua, his able pupils, Fabricius 
and Columbus, carried on after him. 

IMean while John Cains had returned to England, 
three years after the publication of the Fabrica, 
not as a teacher of Greek, but as instructor of 
anatomy for the English barber surgeons. His 
lectures in anatomy became so popular that he 
determined to found a college for those who 
wanted to study medicine. Cains College at Cam- 
bridge began its courses in 1558. By a special 
grant from Henry VIII the college was permitted 
to hold two public dissections a year. The college 
prospered under the direction of its freethinking 
founder, who had a stomach perverse to the clergy. 
Its fame spread over England and reached the 
ears of a Folkstone lad who had a yen for the 
study of medicine. In 1593 this lad, William 
Harvey, was enrolled in Cains College. Four 
years later he graduated as a Bachelor of Arts. 
The spirit of the founder was very much alive 
at Cains during Harvey’s student years. He must 
have heard about the great Vesalius, and about 
Servetus too, for he had described the pulmonary 


circulation a few years after Caius’s return to 
England. Servetus was later burned by the 
bigoted Cah'in in the fire from his own hot tirades 
against the reformer. Harvey might well, as Osier 
suggests, have read Caius’s De Libris Proprics, 
and from that obtained the high opinion of the 
Mater Gloriosa Studiorum at Padua. At any 
rate, Harvey went there for his medicine. 

Harvey enrolled at Padua in 1598. The short, 
raven-haired Briton with the black, flashy eyes 
found that Padua measured fully up to his high 
expectations. He made a good impression on 
fellow students and professors alike, although per- 
haps for different reasons. He was elected repre- 
sentative from Britain to the student organization. 
One of the privileges appertaining thereunto was 
that of getting drunk forty-two times a year! 
Alas, the na'ture of medical students changes but 
little with the passing of centuries ! The faculty 
was impressed from the beginning with the in- 
telligence and industry of the young Englishman. 
When he graduated, his diploma carried the in- 
scription that he had exceeded even the highest 
expectations of his teachers. 

Perhaps it was Fabricius who had insisted on 
that extra bit of praise written on Harvey’s 
diploma. For Fabricius of Aquapendente was at 
that time studying the valves of the veins, and one 
likes to think that young Harvey helped him with 
the dissections. The valves occur at varying inter- 
vals in the lumina of the veins. They close away 
from the heart and permit the blood to flow freely 
toward the organ. Faijricius, who apparently had 
profited by the sad experience of Vesalius, sought 
to explain the function of the valves in such a way 
as to square with Galen’s theories. Harvey heard 
Fabricius again and again state that the valves 
were dams placed in the veins to prevent too much 
blood from ebbing into the extremities. But to a 
Caius-trained man Galen was not the god that he 
w'as at Padua. Harvey must have doubted his 
teacher’s explanation, for as soon as he returned to 
England he continued the study of the valves of the 
veins from the point where Fabricius had left it. 
He began by dissecting all sorts of animals. Even 
his wife’s parrot went under the knife. Harvey 
discovered that the valves were not dams, that 
they entirely closed the lumen of the vessels, that 
valves occurred in the veins going to the head as 
well as in those going to the extremities. Certain- 
ly there was no need for preventing too much blood 
going to the brain. Therefore, Fabricius’s ex- 
planation did not square udth the facts. Further- 
more, the arteries were free from valves except at 
their mouths. Hence, the blood did not oscillate 
l)ack and forth, but was forced to flow to the heart 
in the veins and away from it in the arteries. 


54 


JOUKNAL OF FoWA StATF MeOICAL SOCIETY 


Fcliruar)'. 1945 


Servelus had hold that the hlood eirculate<l from 
the iieart to the lun"s ami hack to the heart only so 
far as the lungs were concerned, that (lalen’s 
theory held for the rest of the body. P>ut llarvey 
found that the artery to the lungs from the right 
ventricle was every hit as large as the one to the 
rest of the body from the left ventricle. The scent 
was warm! Then he removed the breast bone 
from live animals and opened the heart .sac in order 
to observe what was actually going on. At first he 
was disa])])ointed. In the small, warm-blooded 
animals be used, the heart beat so fast that he could 
not tell what was going on. But when the animals 
became moribund tbe story was plain, as it was 
also in all cold-blooded animals, since tbe heart 
beat slowly enough to get a clear picture! During 
systole the heart contracted, became ^mailer and 
anemic, during diastole it dilated and became dis- 
tended with blood. The heart acted as a pump ! 
But he felt that he had to obtain still more proof, 
and therefore made careful measurements of the 
heart chambers and calculated their culiic content. 
He must have been astonished by the large amount 
of blood which his figures showed was expelled 
from the heart every hour. In the slaughter house 
he learned not only how long it took an animal to 
bleed to death from a severed artery, but also bow 
much blood the body actually contained. It was 
clear from tbe facts observed that the pumping 
heart expelled all the blood found in- tbe body, in a 
matter of seconds, not hours. Hence, his observa- 
tions on man and other animals, his physiologic 
experiments and his calculations, proved that 
Galen's theories were erroneous. Harvey's in- 
vestigations indicated that the blood was pumped 
from the heart into the arteries and returned to the 
organ via the veins, and that it circulated con- 
stantly through the body by the force exerted by 
the contracting ventricles. 

He demonstrated his experiments and advanced 
his conception of the circulation of the blood in bis 
first Lumleian lecture, given before the Royal Col- 
lege of Physicians in the year 1616. For twelve 
years thereafter he continued to expound his views 
and to add further proof to substantiate his con- 
ception of the circulation. Finally, in 1628, he 
published the result of his work in the most famous 
of all books on tbe heart. De Mofii Cordis. Thus 
Harvey lifted single-handed, almost the whole Cape 
of Cardiology out of the Sea of the Unknown. 

I am not aware that the college of distinguished 
physicians ordered a celebration in honor of bis 
discovery at the time that the announcement was 
made, but that same body and many similar so- 
cieties have held any numlier of special “Harvey 
meetings” since. Such celebrations are indeed 
fitting and proper because by his toil, Harvey be- 


came the h'atber of Cardiology. Mis claim to dis- 
tinction rests not only on bis discovery, but also 
on tbe fact Ibal his methods are responsible for the 
])rogress made in cardiology since his day. Indeed, 
they’ are the methods of Science res])onsible for 
any a<lvancement of knowledge. Harvey familiar- 
ized himself with the facts and the theories held 
by the generations before him. He carefully 
weighed them ; then by his own observations, by 
his experiments on man and other animals, and by 
accurate measurements and calculations, be ob- 
tained factual information from which he drew 
new logical and valid conclusions. 

d he influence of Harvey upon scientific medicine 
cannot be overstated ; yet, bis work was coolly 
received. A number of his colleagues who listened 
to him in 1616, did not even mention his discovery 
in treatises on anatomy which they later wrote. 
One “stuffed shirt,” a Sir somebody, delivered him- 
self of an oracular utterance which he likely 
thought was the final judgment on the work of 
Flarvey. According to the baronet, Harvey must 
indeed have worked hard to have produced his 
Motii Cordis, and it must have been a great satis- 
faction to him to have accomplished so much, but, 
of course, sucb efforts could have no influence on 
clinical medicine ! The young physicians, fired 
with the spirit of the Renaissance, cheerfully ac- 
cepted Harvey’s views, but some professors in high 
jilaces abroad, notably Potain of Paris, bitterly 
assailed tbem, and there were many -in England 
who were eager to throw mud at the “Circulator.” 
.Some of Cromwell’s rabble actually entered Har- 
vey's house and burned many of his manuscripts. 
However, by the end of the century Harvey’s 
views were held by most physicians. By this time, 
too, the new spirit had permeated the entire medical 
profession. Progressive men sought to learn by 
careful observation rather than from the theories 
of the ancients. 

Harvey’s work on the circulation focused men’s 
attention upon the heart and its diseases. During 
the eighteenth century the Cape of Cardiology was 
lifted further out of the Sea of the Unknown by 
the work of physicians in many lands. With one 
exception, the giants of that century : Vieussens 
(1641-1716), Lancisi (1655-1720), Albertini 
(1662-1738), Senac (1693-1770), Morgagmi 
(1681-1771), and Heberden (1710-1801) were 
not of conspicuous size. Their contribution con- 
sisted of careful clinical observation, feeble at- 
tempts at physical diagnosis, and thorough study of 
the morbid changes found at the autopsy table. 
From their studies they sought to understand the 
nature of cardiac disorders and to de-\’elop a ration- 
al therapy. And, toward the end of the eighteenth 
century, in the short space of a little over a hun- 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


55 


dred years, the function of the heart had lieen es- 
tablished. It had been conclusively shown that 
the vital pump, which since Hippocratic times 
had been held to be immune to disease, was as sus- 
ceptible as any other organ to morbid changes ; in- 
deed. that failure of this organ was frequently the 
sole cause of death. 

The incompleteness of medical knowledge which 
existed at the end of the eighteenth century was 
due neither to lack of intelligence nor to lack of in- 
dustry on the part of its ])hysicians. The help of 
the natural sciences was needed, and also the 
knowledge of micro-organisms before tbe signs of 
cardiac disease in the living could be accurately 
detected, and the nature of many cardiac disorders 
understood. 

Fortunately, the whole Island of the Known 
was ra]iidly enlarging: Natural Science was grow- 
ing fast. In 1609 Kepler published his Astronom- 
ica Nova; in 1610 Galileo invented the compound 
microscope : in 1620 Yon Helmholz demonstrated 
the conservation of matter, and in 1687 Newton 
published his Principia. Such remarkable ad- 
vancement of Natural Science profoundly affected 
man’s attitude toward bimself and bis universe. 
During the long centuries when bishops controlled 
human thought, man was considered to be some- 
tbing apart from the rest of nature. He came into 
being by a special creation, was, so to speak, the 
pet of the Creator, and had priority claim on His 
power. So long as man remained in good stand- 
ing with his IMaker he was protected from the 
fierce natural forces which raised havoc with the 
rest of creation. However, after the publication 
of the Principia, it dawned more and more on 
thinking man that he was but a part of the whole, 
that the laws which governed X^ewton's apple were 
equally applicable to himself. From that day 
until this, man has assiduously studied natural law 
for his own protection and for the better under- 
standing of himself. 

BLOOD PRESSURE 

It is a bit odd that a “sky pilot” should have 
been the first to apply the methods of physics to 
the study of human physiology. Rev. Stephen 
Hales (1677-1761) must have loved science more 
than theology, for he was busy studying natural 
jihenomena. Fie developed a water supply system 
for his parish, artificial ventilation for a nearby 
prison, and published many statistical volumes on 
his experiments. It occurred to him one day to 
measure the force exerted by the contracting heart. 
He took a mare, tied her down on her liack, slit 
the skin in the neck, found the artery going to the 
brain, and inserted a canula to which was attached 
an upright glass tube, and proceeded to record tbe 


height of the blood column in systole and diastole. 
He bad taken the first blood pressure readings and 
bad extended the Cape of Cardiology a bit farther 
into the Sea of the Unknown. One can readily 
imagine “wise” physicians of his day feeling per- 
fectly certain that Hales’ experiment had no prac- 
tical value whatever. For centuries it didn’t! 
Even during my medical school days none of the 
teachers mentioned blood pressure, but today no 
physical examination is made without recording it. 
It is now known that high blood pressure kills 
more persons than cancer and tuberculosis com- 
bined. 

PERCUSSION 

In the middle of the eighteenth century there 
lived in the town of Graz, Austria, an innkeeper, 
whose son, Leopold, had a musical ear. One can 
imagine the little boy trotting into the cellar after 
his father as he drew beer or wine for his cus- 
tomers. The boy noticed that the father knocked 
on the barrel staves when he wanted to find out 
how much beer was left. Above the beer level the 
barrel was resonant; below tbe level it was dull. 
During the extremely full years at the medical 
school in Vienna, Leopold forgot the kegs in his 
father’s cellar. Later when he worked as assistant 
to the clinic and still later as chief of the hospital 
of the Holy Trinity, he had opportunity again and 
again to observe gross lesions in the chest at 
necropsy which had been overlooked in the clinic. 
The hospitals in Vienna, then as now, were filled 
with chest-sick people. Fluid in the pleural sac 
is an exceedingly common finding at post mortem 
in such cases. -Yet. the Viennese doctors were 
unable to recognize the fluid during life. It must 
have been while pondering this fact that Leopold 
Auenbrugger recalled his experience with the beer 
barrels. He tried knocking on patients’ chests, and 
perhaps he tapped one in whom he suspected the 
presence of pleural fluid. He must have growm 
excited when he found the fluid at autopsy in the 
place where he had detected dullness. He had dis- 
covered a new method of obtaining accurate in- 
formation about normal and abnormal conditions 
in tbe chest. For six years he and his assistants 
thumped chests, made notes of their findings, and 
verified their impressions at the autopsy table. 
Then, in the same year that Morgagni published 
De Scdihus, he sent to the printers his hwentu-in 
Novitni, a ninety-six ]>age treatise on percussion. 
Auenbrugger states : “I am not moved to write by 
an itch for writing but by a desire to impart to my 
ju'ofession what I have discovered.” The book 
was brief. Van Swieten, his chief, had advised 
lum to be brief if he had to write at all! But the 
I'nventum was accurate and clear. Still, the author 


56 


Journal of Iowa Static Micdtcal Society 


Fcljniary, 1945 


(lid not expect liis contril)ution to l)e accepted by 
the InJ^h and mighty Van Swieten at the medical 
school, and why should the Baron learn from the 
son of a Grat/.ian innkeeper! Why should the 
“Teat Van Swieten, pn]>il of the immortal Boer- 
have, who marched at the head of a mighty army 
of admirers through the wards at the Kranken- 
hans, listen to the peasant’s son from Graz. So 
the medical army under Van Swieten continued to 
stamp through the wards at the Krankenhaus and 
to listen reverently to the baron’s discussions on 
“Heimweh.” The Inventum Novum “fell flat.” 
The new part of cardiology, which Leopold Auen- 
hrugger had lifted from the Sea of the Unknown, 
slowly and almost completely sank back from 
whence it came. For forty years percussion re- 
mained an almost forgotten medical art.' Yet there 
were persons at the Holy Trinity Hospital who did 
not quite forget what Auenhrugger had taught. 
One of these was Max Stahl, who left Vienna to 
seek greener pastures in Paris and brought the 
memory of the pompous V an Swieten, his medical 
ward army, and a copy of the Inventum Novum 
with him. When he observed that Corvisart was 
trying to develop real clinical courses at the Ghar- 
ite, he evidently told the great French cardiologist 
how clinics were conducted in Vienna. ■ Corvisart 
liked the idea of a ward army and copied it. When 
Stahl heard Corvisart complain of his inability to 
make correct chest diagnosis, he handed him a copy 
of the Inventum Nomim. The great French 
cardiologist liked the book too. 

When Corvisart found that he could verify the 
statements made by Auenhrugger, he began to 
practice percussion on all his patients. One can 
imagine the impressive thumping of chests carried 
on by the medical army trailing after him through 
the wards. The thumping became the talk of the 
town. Even Napoleon heard about it; and when 
the General had a chest cold, Josephine sent for 
the thumper. From then on the two men were 
friends and buddies. 

During the first decade of the nineteenth century 
the College of France attained its “Glanz” period. 
Strong progressive men dominated the various 
departments and by brilliance of intellect and dili- 
gence secured a name for themselves and glory for 
Parisian medicine. Young doctors from the old 
and the new world flocked tO’ Paris. It was during 
that decade that Corvisart eloquently held forth 
on cardiac disorders and on the value of percus- 
sion to the admiring doctors who tramped with 
him through the wards at the Charite. 

auscultation 

In that clinical group was a thin little Breton 
who, after many trials and tribulations, had suc- 


ceeded in enrolling in the service of the great 
Corvi.sart. The young man was 'rheo])hilc Laen- 
ncc. His uncle, Guillaume, had inspired him to 
study medicine rather than theology and liad final- 
ly forced enough money from Theo]jhile’s im- 
provident father to permit the brilliant son to en- 
roll. This had not happened, however, before 
4’heophile had taken twice all the courses offered 
at his uncle’s school at Nantes! Uncle Guillaume 
was filled with the new spirit of medicine, for he 
had been in England and had come under the spell 
of that redheaded roughneck, John Hunter, who 
became father of experimental surgery. This vig- 
orous, daring Scot had no use for old theories. 
To him knowledge could only be acquired by per- 
sonal observation and experimentation. The uncle 
must have told his nephew, again and again, about 
the great Britisher and have mentioned with pride 
the fact that France had a giant of its own — the 
percusser, Corvisart. Hence, young LaGinec be- 
came a devoted follower of the great French car- 
diologist. Before entering Corvisai't’s service, 
Theophile had distinguished himself as a morbid 
-anatomist, had pulilished many excellent papers, 
and had won so many prizes that other contestants 
refused to enter when they learned that the young 
Breton was a contestant. Laennec had a special 
interest in the clinical phases of diseases of the 
chest because, like Bayle, who was his senior on 
Corvisart’s service, he, too, was a “lunger.” 

By 1816 Laennec had been appointed chief of 
medicine at Necker Hospital where he had ample 
opportunity to study chest cases. Flis training in 
morbid anatomy, his tutelage under Corvisart, and 
his own observations on 600 clinical cases made 
him well equipped to solve problems in the pathol- 
ogy of the chest. Just as Corvisart had been es- 
pecially interested in cardiac diseases, Laennec, 
wdrose own lungs continued to bother him, was 
eager to learn about the clinical manifestations of 
the morbid changes in the lungs. One can imag- 
ine the young chief attacking chest problems at 
The Necker with true “Laennecian” energy. But 
he must have been discouraged and disgusted many 
times during his first year there. In spite of care- 
ful history-taking, inspection, palpation, and per- 
cussion, it happened too frequently that the pathol- 
ogist found conditions present at autopsy that had 
not been suspected on the wards. The gap be- 
tween the clinical and the anatomic diagnosis was 
far too wide to suit the former exacting morbid 
anatomist. 

One day there appeared at The Necker an obese 
voung woman who obviously had heart disease. 
Percussion was unsatisfactory. Laennec wondered 
whether the sounds in the thorax itself would not 
furnish helpful hints, Flippocrates had taught that 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


57 


the physician should place his ear against the naked 
chest of the patient to listen for sounds. Robert 
Hooke had stated a century before that one could 
hear the heart sounds, the wheezing noises of the 
air passing in and out of the bronchi, and the rum- 
blings of the bowels. In Corvisart’s Clinic direct 
auscultation had sometimes been practiced. At the 
Charite such auscultation had not been of much 
help, and Laennec did not like the procedure. It 
confused him because he was asthmatic and be- 
came short o-f breath when he stooped to listen. 
He was naturally modest and embarrassed at sucb 
intimate contact with female skin, and what was 
still worse was that many of the patients had lice. 
Yet, he tried to listen to the fat woman’s heart, 
heard nothing, left the patient, disgusted, and did 
what most Parisians do to soothe “their savage 
breasts’’ — went for a walk in the beautiful gardens 
of the Louvre. Even this beauty spot was untidy 
at that time, for France had just gone through its 
bloody revolution, and with “Liberte, Ecjualite — 
Fraternite’’ ringing in his ears, the caretaker let 
the rubbish accumulate. On top of a pile of trash 
lay a long wooden beam. The promenading doc- 
dor noted that a flock of urchins were having a 
delightful time playing with it. One group was 
tapping at one end while the others listened at the 
opposite end. Laennec saw and understood. He 
wheeled around, rushed back to the hospital and 
over to the fat lady. To the astonishment of the 
hospital personnel and the patient, he grabbed 
a paper-covered book, rolled it up into a cylinder, 
l>ut one end over the patient’s heart, the other end 
to his ear. For the first time man heard the lub- 
dub of the heart beat and perhaps also a murmur. 
The sounds of the chest had been made audible. 
The stethoscope had been invented. A new large 
part of tbe Cape of Cardiology had been raised out 
of the Sea of the Unknown! 

The idea which starts an invention or a discov- 
ery is often followed by a strong sustained desire 
to make the new as perfect as possible. Little Secco, 
as Madame Chateaubriand called Laennec, and 
who was known to medical circles in Paris for his 
indefatigable energy, fully realized that the chil- 
dren on the beam had opened new medical horizons. 
Under the spell of the urge to explore its possi- 
bilities, he redoubled bis energies. The cylinder 
had to be improved. He bought himself a lathe 
and proceeded to turn out tubes from many types 
of wood. He tried solid cylinders and hollg, 
ones, hdnally, he was satisfied that a twelve- 
two-piece cylinder made of soft wood funct 
best. He began mediate auscidtation, over n 
and abnormal lungs and hearts. Uien Lae: 
the writer, tried to describe the sounds heard o’ 
the chest. Since his ears were the first to 


he had to invent new words and phrases to de- 
scribe them. iMany of his terms are in use at 
present. 

When the fact that he was “auscultating” got 
around, the procedure became popular. Others 
wanted tbe credit for tbe discovery and began to 
write and talk aliout it as of their own making. 
Laennec, who fully realized how much more there 
was to be learned about mediate auscultation, was 
forced to present before the Academy of Science, 
A Memoir of Auscultation (1818). It was listened 
to by the learned doctors with respect but without 
the slightest trace of enthusiasm. They refrained 
from committing themselves ! It evidently took 
more than a memoir to put auscultation over. But 
Laennec was exhausted and discouraged. He left 
Paris and went for a much needed vacation to Brit- 
tany. When he returned to The Necker, he re- 
ceived a rousing welcome from his associates. 
Rested and cheered by the loyalty of those who 
had worked with him, he set about to complete 
the work he had planned. He tinkered with the 
cylinder which hy now had become the high-falut- 
ing stethoscope, and he revised and enlarged vari- 
ous chapters of his book on auscultation. It was 
to be a treatise on the diseases of the chest in the 
light of inspection, palpation, and auscultation. 

In 1819 the Traite tie V Auscultation came off the 
press. It was in two volumes and sold for eighteen 
francs. The price of the book included a well 
turned-out walnut stethoscope, so that anyone who 
bought the book could determine for himself the 
value of the new method. The book and stetho- 
scope were Laennec’s answer to the silence of his 
colleagues and to the jibes of the scoffers. I won- 
der if the deeply religious Theophile sent the book 
out with a prayer that his profession would at 
least try the new method before condemning it. 
If he did, the prayer was unanswered, at least for 
a season, for the book was resented by his col- 
leagues. The doctors who tried auscultation were 
looked upon as charlatans and the stethoscope was 
ridiculed in poetry and cartoon. The high-strung, 
sick, overworked Laennec “could not take it.” He 
did not, like Vesalius, burn his books. He gave 
them away, resigned his position at The Necker, 
and fled back to his beloved Brittany to seek peace 
by working on the very soil under which so many 
of our own boys have found everlasting peace. 

is to escape tbe trials and trilnt- 
of medicine. He came to 
speii(4.^uK money on the ancestral es- 
country squire, and to 



all, that tired all-in after- 
thosejferrible night sweats, which 
n he over-did and the world 
him. Fie trot rid of his 


58 


Journal of Fowa State Medical Society 


Feliruary, 1945 


money fast enough, too fast to suit a frugal 
l‘'renchniau. 'I'he country s(|uire existence was 
delightful for a season. Ifut tlien, that insistent 
longing, “'I'o follow knowledge like a sinking star,” 
came hack. He returned to Paris in 1821 and 
found himself famous. All copies of his hook had 
been sold. The stethoscope-makers were doing a 
rushing business ; auscultation was going over in a 
big way. The new method spread like a prairie 
lire over the medical world. Its discoverer was 
a])])ointed royal lecturer at the Medical School 
( 1822) and became a member of the Legion of 
Honor (1824). 

By auscultation anyone who has normal ears, a 
modicum of brain, and the will to learn, can obtain 
a far more accurate picture of disease, process in 
the chest than was possible prior to 1819. No 
doctor now would think of practicing without a 
stethoscope. By his sweat, blood, and tears Laen- 
nec greatly narrowed the gap between clinical and 
anatomic diagnosis of chest lesions. But he flid 
not close it ! 

ROENTGENOLOGY 

Man perceives the manifestations of disease 
through his senses. The principal reason that the 
medical profession remained ignorant about dis- 
eases of the chest for centuries was that the ob- 
servers could not look into the living man’s thorax. 
Not even the most visionary dreamed that some 
day it might he possilde actually to see the work- 
ings of the lungs and the heart. This miraculous 
achievement was made possible by Roentgen. In 
1888 AVilliam Conrad Roentgen was elected pro- 
fessor of physics at the Lhiiversity of Wurzburg. 
This happened just a few' years after the faculty 
of that institution had refused to grant him a 
higher degree liecause he did not know enough. 
Since his failure to measure up to their standard, 
Roentgen had so distinguished himself that by 1888 
the University of Wurzburg had to compete with 
that of Jena 'to procure him to head its physical 
institute. 

During the nineteenth century physics had made 
tremendous forward strides. By 1890 many well 
equipped physical laboratories were able to gen- 
erate strong induction currents. During the dec- 
ade which followed, physicists became interested 
in the effect produced by passing a high tension 
induction current through a vacuum tube. This 
jjroblem interested Roentgen also. He secured a 
Ruhmkorff induction coil and Hittorf-Crookes 
vacuum tulies. Because he w'ished to repeat the 
work on the cathode rays done by Hertz and Len- 
ard. he also obtained the armamentarium employed 


by them. 'I'his consisted of Lenard’s tubes, a fluor- 
e.scent screen, and photograjihic jilates. Roentgen, 
like others in search of new knowledge, had dis- 
covered that research is best done in the evening 
after the day’s routine is over and the assistants 
have gone home. On the evening of November 
28, 1895, the professor was in his laboratory, mon- 
keying with his apparatus in the dark. The Lenard 
and the Crookes tubes w'ere .standing on a table 
near the screen. On a table some <li.stance away 
lay a paper which had been im])regnated wdth the 
huorescent crystals of platinum barium cyanide. 
He had already completed the Hertz-Lenard’s 
experiment, which consisted of sending the cur- 
rent through a Lenard tube, covered with black 
paper w'hich had a round hole that jiermitted the 
cathode ray to pass to the fluorescent screen. 
Next he covered the Crookes tube with black paper 
and sent the current through it, presumably to test 
the black covering. While the switch was on, 
Roentgen happened to glance toward the barium 
jilatinum paper. To his astonishment, it glowed ! 
He tried the screen ; it, too, fluoresced ! He moved 
the tube well out of range of the cathode ray : 
still the light came through ! He put his hand 
betw'een the tube and the screen. The shadows 
of the bones and muscles of his hand showed on 
the screen ! Then he put a book in front of the 
tube : still the light came through. Roentgen had 
discovered a new Ray! Now he would have to 
determine its nature and characteristics : and do 
it alone! Under the stimulus of the new discov- 
ery, he worked hard. None but his wife knew 
what was .going on. She described him as eating 
very little,' sleeping less, and being taciturn and 
grouchy during the days preceding December 28, 
1895. On that day he handed a manuscript with 
the title “Line neue Art von Strahlen,” to the pres- 
ident of the Physical Medical Society of Wurz- 
burg. Roentgenology was born ! 

The discovery was enthusiastically received all 
over the world. Today no doctor of medicine 
w'illingly practices without the aid of roentgen 
rays. The value which has accrued to the sick 
from the use of the ray in diagnosis and treat- 
ment is stupendous. Roentgenology closed the 
gap between clinical and anatomic diagnosis in 
disease of the lungs. It greatly narrowed that gap 
in the diagnosis of heart disease. But it did not 
close it ! In order to be able to make a reasonably 
accurate clinical diagnosis of all types of heart 
disease, medicine required more help from the 
science of physics and it received this in the form 
of electrocardiography. 

(To be continued) 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


59 


As of Januar 

Adair County 

Cornell, D. D., Greenfield (APO 41, San Francisco, 

Cal.) Capt., A.U.S. 

Gantz, A. J., Greenfield (APO 951, San Francisco, 

Cal.) Capt., A.U.S. 

Adams County 

Bain, C. L., Corning (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Willett, W. J„ Carbon (APO 230, New York, N. Y.).Capt., A.U.S. 

Allamakee County 
Hogan, P. W., Waukon 
Ivens, M. H., Waukon (Camp Shelby, La.) 

Kiesau, M. F., Postville (Jefferson Barracks, Mo.).. Major, A.U.S. 

Rominger, C. R., Waukon (Camp 'Claiborne, La.) A.U.S. 

Appanoose County 

CAndon, F. J., Centerville (Owensboro, Ky.).. Major. U.S.P.H.S. 

Edwards, R. R., Centerville (Richmond, Va.) Capt., A.U.S. 

Huston, M. D., Centerville (Camp Bowie, Texas) .. Capt., A.U.S. 
Audubon County 

Koehne, F. D., Audubon (APO 520, New York, 

N. Y.) Major, A.U.S. 

Benton County 

Koontz, L. W., Vinton (APO 7. San Francisco, Cal.) Capt., A.U.S. 
Senfeld, Sidney, Belle Plaine 

Black Hatyk County 

Bickley, D. W., Waterloo (APO New York, N. Y.) .Capt., A.U.S. 
Bickley, J. W., Waterloo (APO 956, San Francisco, 

Cal.) Capt., A.U.S. 

Butts. J. H.. Waterloo (Galveston, Texas) Comdr., U.S.N.R. 

Cooper, C. N.. Waterloo (Ottumwa, Iowa) . .Lt. Comdr., U.S.N.R. 
Ericsson, M. G., Cedar Falls (Camp Barkeley, Tex.) Capt., A.U.S. 
Hartman, H. J., Waterloo (APO 33, San Francisco. 

Cal.) • Capt., A.U.S. 

Henderson, L. J., Cedar Falls (APO 782, 

New York, N. Y.) Major, A.U.S. 

Hoyt, C. N.. Cedar Falls (APO 635, New York. 

N. Y.) Capt... A.U.S. 

Ludwick, A. L., Waterloo (Abilene. Texas) Major. A.U.S. 

Marquis, F. M., Waterloo (APO 17321, New York, 

N. Y.) Capt., A.U.S. 

O’Keefe, P. T.. Waterloo (APO 79, New York. 

N. Y.) Capt., A.U.S. 

Paige, R. T., LaPorte City (Banana River, Fla.) . Comdr.. U.S.N.R. 
Rohlf. E. L.. Jr.. Waterloo (APO 230, New York, 

N. Y.) Major, A.U.S. 

Seibert, C. W., Waterloo (Colorado Springs, Colo.) . .Major, A.U.S. 
Smith, E. E., Waterloo (APO 709, San Francisco, Cal.) 

Major, A.U.S. 

Smith, R. L, Waterloo (Milwaukee, Wis.) Capt., A.U.S. 

Smith. R. G.. Cedar Falls (APO 512, New York. 

N. Y.) Major, A.U.S. 

Trunnell, T. L., Waterloo (Parris Island, S. Car.) .. .Lt. U.S.N.R. 

Boone County » 

Brewster, E. S., Boone (APO 446, New York, N. Y.) .Major, A.U.S. 

Healy. M. J., Boone (Camp Chaffee, Ark.) Capt., A.U.S. 

Shane, R. S„ Pilot Mound (Des Moines, la.) Lt. Col., A.U.S. 

Bremer County 

Blum, O. S., Waverly (Fleet PO. San Francisco, 

Cal.) Lt.. U.S.N.R. 

Rathe, H. W„ Waverly (APO 209, New York, N. Y.) 

Major, A.U.S. 

Shaw, R. E., Waverly (Long Beach, Cal.) 1st Lt., A.U.S. 

Buchanan County 

Barton. J. C., Independence (APO 314, New York, 

N. Y.) Lt. Col., A.U.S. 

Hersey, N. L., Independence (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Leehey, P. J., Independence (APO 244, San Francisco, 

Cal.) Capt., A.U.S. 

Loeck, J. F., Aurora (APO 9787, New York, N. Y.) . .Capt., A.U.S. 

Buena Vista County 

Almquist, R. E.. Albert City (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Brecher, P. W., Storm Lake (Camp Adair, Ore.)..Lt. Col., A.U.S. 

Hansen, R. R., Storm Lake (Farragut, Idaho) Lt., U.S.N.R. 

Mailliard, R. E., Storm Lake (APO 254, New York, 

N. Y.) Lt. Col., A.U.S. 

Shope, C. D., Storm Lake (Fort Des Moines, la.) . .Capt., A.U.S. 
Witte, H. J., Marathon (Fort Crook, Nebr.) Major, A.U.S. 

Butler County 

Andersen, B. V., Greene (Fleet PO, Seattle, Wash) .Lt., U.S.N.R. 
James. R. A., Allison (Mare Island, Cal.) 

Rolfs, F. O., Parkersburg (Springfield, Mo.) 1st Lt., A.U.S. 

Calhoun County 

Grinley, A. V., Rockwell City (APO 350, New York, 

N. Y.) Capt., A.U.S. 

Hobart, F. W., Lake City (Camp Grant, 111.) Capt., A.U.S. 

McVay, M. J.. Lake City (Waco. Texas) Capt., A.U.S. 


y 25, 1945 

Peek, L. H., Lake City (Jefferson Barracks, Mo.) .. Capt., A.U.S. 

Stevenson, W. W., Rockwell City (Fleet PO, San 

Francisco, Cal.) Comdr., U.S.N.R. 

Weyer, J. J., Lohrvflle (APO 465, New York, 

N. Y.) Capt., AU.S. 

Carroll County 

Anneberg, A. R., Carroll (Camp Barkeley, Texas) A.U.S. 

Anneberg, W. A.. Carroll (APO 367, New York, 

N. Y.) Capt., A.U.S. 

Cochran, J. L., Carroll (Gulfport, Miss.) 

Cross, D. L., Coon Rapids (Fleet PO, San Francisco, 

Cal.) Lt.. U.S.N.R. 

Freedland, Maurice, Coon Rapids 

Morrison, J. R., Carroll (Ft. Dix, N. J.) Capt., A.U.S. 

Morrison, R. B., Carroll (APO 634, New York, 

N. Y.) Capt., A.U.S. 

Pascoe, P. L.. Carroll (Bowman Field, Ky.) Capt., A.U.S. 

Scannell, R. C., Carroll (Denver, Colo.) Capt., A.U.S. 

Tindall, R. N., Coon Rapids (Hines, 111.) Major, A.U.S. 

Wyatt, M. R., Manning (De Ridder, La.) Capt., A.U.S. 

Cass County 

Egbert, D. S„ Atlantic (APO 218, New York N. Y.) 

Major. A.U.S. 

Needles, R. M., Atlantic (APO 131, New York, 

N. Y.) Capt., A.U.S, 

Petersen. M. 'I'., Atlantic (Topeka. Kan.) Capt., A.U.S. 

Schiff, Joseph, Anita (Walla Walla, Wash.) 1st LL, A.U.S. 

Cedar County 

Laughlin, R. M., Tipton (San Diego, Cal.) Lt., U.S.N.R. 

Mosher, M. L., West Branch (APO 560, New York, 

N. Y.) Capt., A.U.S. 

O’Neal, H. E., ’Tipton (Camp Maxey, Texas) Lt. Col., A.U.S. 

Cerro Gordo County 

Adams, C. O., Mason City (Vancouver, Wash.l Capt., A.U.S. 

Egloff, W. C., Mason City (APO 17130, New York; 

N. Y.) Capt., A.U.S. 

Flickinger, R. R., Mason City (Memphis, Tenn.) .... Capt., A.U.S. 

Hale, A. E., Dougherty (Atlanta, Ga.) Capt., A.U.S. 

Harris, R. H., Mason City (Dyersburg, Tenn.) Capt., A.U.S. 

Harrison, G. E., Mason (lity (APO 365, New York, 

N. Y.) Col., A.U.S. 

Houlahan, J. E., Mason City (APO 838, New Orleans, 

La.) Capt., A.U.S. 

Lannon, J. W., Clear Lake (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Long, D. L., Mason City (APO 520, New York, 

N. Y.) Capt., A.U.S. 

Morgan, P. W., Mason City (Camp Butner, 

N. Car.) Capt., A.U.S. 

Marinos, H. G., Mason City (Denver, Colo.) Capt., A.U.S. 

Sternhill, Irving. Mason City (Ayer, Mass.) Capt., A.U.S. 

Clierokee County 

Bullock, G. D„ Washta (APO 17583, New York, 

N. Y.) Capt., A.U.S. 

Ihle, C. W., Jr., Cleghorn (APO 6, San Francisco, 

Cal.) Major, A.U.S. 

Swift, C. H., Jr., Marcus (APO 201, San Francisco, 

Cal.) Capt., A.U.S. 

Chickasaw County 

Caulfield, J. D., New Hampton (APO 178, New York, N. Y.) 

Major, A.U.S. 

Murphey, A. L., Fredericksburg (Hot Springs, Ark.) Capt., A.U.S. 

O’Connor, E. C., New Hampton (Redmond, Ore.) ... Capt., A.U.S. 

Richmond, P. C., New Hampton (APO 88, New York, 

N. Y.) Major, A.U.S. 

Clarke County 

Armitage, G. I.. Murray (Carlisle Barracks, Pa.) .. 1st Lt., A.U.S. 

Clay County 

Edington, F. D., Spencer (APO 629, New York, 

N. Y.) Col., A.U.S. 

Jones, C. C., Spencer (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

King, D. H., Spencer (Peterson Field, Colo.) Capt., A.U.S. 

Clayton County 

Andersen, H. M., Strawberry Point (Springfield 
Mo.) Capt., A.U.S. 

Glesne, O. G., Monona (Knoxville, Iowa) Capt., A.U.S. 

Rhomberg, E. B., Guttenberg (APO 584, New York, 

N. Y.) Capt., A.U.& 

Clinton County 

Amesbury, H. A., Clinton (Vancouver, Wash.) Capt., A.U.S. 

Burke. J. C., Clinton (Great Bend, Kan.) A.U.S. 

Ellison, G. M.. Clinton (APO 9030, New York, 

N. Y.) Capt., A.U.S. 

Hill, D. E.. Clinton (APO 9787, New York, N. Y.) ... Capt., A.U.S. 

King, R. C.. Clinton (APO 403, New York, N. Y.)...Capt. A.U.S. 

Lenaghan, R. T., Clinton (Fleet PO, San Fran- 
cisco. Cal.) Lt. Comdr., U.S.N.R. 


60 


JoruNAf, OF Iowa Statf. INIkdical Socikty 


Fel)ruary, 1945 


Norment, J. E.. Clinton (Washington, D. C.) 

Lt. Comdr., U.S.N.R. 

Riedesel, E. V., Wheatland (Fort Douglas, Utah) 

Scanlan, G. C., DeWitt (Carlisle Barracks, Pa.) . . • . Capt., A.U.S. 
Snyder, D. C., De Witt 

Speigel, I. J., Clinton (Galesburg, 111.) Capt., A.U.S. 

Van Epps, E. F., Clinton (APO 9921, New York, 

N. Y.) Capt., A.U.S. 

Waggoner. C. V.. Clinton (Fleet PO. San Francisco. 

Cal.) I,t. Comdr.. U.S.N.R. 

Wells. L. L., Clinton (APO .’)62, New York, N-. Y.) . .Capt., A.U.S. 


Crawford County 

Fee, C. H., Denison (APO G96, New York, N. Y.) . Major, A.U.S. 

Grau, A. H., Denison, (Fleet PO, San Francisco, 

Cal.) Lt. Comdr.. U.S.N.R. 

Maire. E. J., Vail (APO 18085, New York, N. Y.) . . .Capt., A.U.S. 

Wetrich, M. F., Manilla (APO 986. Seattle, Wash.) . .Capt., A.U.S 

Dnllas-Guthrie Counties 

Butterfield, E. T., Dallas Center (Fort Sheridan, 

111.) 1st Lt., A.U.S. 

Bvrnes, A. W., Guthrie Center (Fort Custer, Mich. ). Major. A.U.S. 

Fail, C. S., Adel (Fleet PO, San Francisco, Cal.) Lt U.S.N.R. 

Margolin, J. M., Perry (APO 5816, New York, 

N. Y.) Capt., A.U.S. 

McGilvra, R. I., Guthrie Center (Ames. Iowa) Lt., U.S.N.R. 

Mullmann, A. J., Adel (APO 17558. San Fran- 
cisco, Cal.) Capt., A.U.S. 

Nicoll, C. A., Panora (APO 349, New York, N. Y.) . .Major, A.U.S. 

Osborn, C. R.. De.xter (Fleet PO. San Francisco. 

Cal.) Lt., U.S.N.R. 

Todd, D. W., Guthrie Center (APO 2, New York, 

N. Y.) Capt., A.U.S. 

Wilke, F. A., Woodward Capt., A.U.S. 

Davis County 

Fenton, C. D., Bloomfield (APO 5253, New York, 

N. Y.) Capt., A.U.S. 

Gilfillan, G. W„ Bloomfield (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Decatur County 

Garnet, E. E., Lamoni (APO New York, N. Y.) .... Capt., A.U.S. 

Delaware County 

Baumgarten, Oscar, Earlville (APO 689, New York, 

N. Y.) Capt., A.U.S. 

Clark, R. E., Manchester (APO 419, New York, N. Y.) 

Capt., A.U.S. 

Des Moines County 

Eigenfeld, M. L., Burlington (Cleveland, Ohio) ... 1st Lt., A.U.S. 

Heitzman, P. O.. Burlington (F'ort Lewis, Wash.) . . .Capt., A.U.S. 

Jenkins, G. D., Burlington (West Point, N. Y.) . . . Lt. Col., A.U.S. 

Lohraann, C. J.. Burlington (APO 708, San Fran- 
cisco, Cal.) Major, A.U.S. 

McKitterick, J. C., Burlington (Hamilton, 

R. I.) Comdr., U.S.N.R. 

Moerke, R. F., Burlington (APO 565, San Francisco, 

Cal.) Capt., A.U.S. 

Sage, E. C., Burlington (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 


Dickinson County 

Buchanan, J. J., Milford (Santa Ana, Cal.) Lt., U.S.N.R. 

Henning, G. G., Milford (APO 96, San Francisco, 

Cal.) Major, A.U.S. 

Nicholson, C. G., Spirit Lake (Sawtelle. Cal.) Capt., A.U.S. 

Rodawig, D. F., Spirit Lake (Hot Springs, Ark.) . . .Major, A.U.S. 

Dubuque County 

Anderson, E. E., Dubuque (Bradley Field, Conn.)-. . .Capt., A.U.S. 

Beddoes, M. G., Cascade (APO 709, San Francisco, 

Cal.) Capt., A.U.S. 

Conzett, D. C., Dubuque (APO 887, New York, 

N. Y.) Lt. Col., A.U.S. 

Cunningham, J. C., Dubuque (Fairfield, Ohio) Capt., A.U.S. 

Edstrom, Henry, Dubuque (APO 645, New York, N. Y.) 

Major, A.U.S. 

Entringer, A. J., Dubuque (APO 41, San Francisco, 

Cal.) Capt., A.U.S. 

Hall, C. B., Dubuque (Camp Shelby, Miss.) Capt., A.U.S. 

Knoll, A. H,, Dubuque (San Francisco, Cal. I Major, A.U.S. 

Langford, W. R., Epworth (Miami Beach, Fla.) .... Capt., A.U.S. 

Lavery. H. B., Dubuque (Washington. D. C.) Lt Col.. A.U.S. 

Leik, D. W., Dubuque (Wichita Falls, Tex.) Capt., A.U.S. 

Mueller. J. J., Dubuque (APO 230, New York, N. Y.) Capt., A.U.S. 

Olson, P. F., Dubuque (Mare Island, Cal.) . .Lt. Comdr., U.S.N.R. 

Painter. R. C., Dubuque (Salt Lake City, Utah) .... Lt., U.S.N.R. 

’’aulus, J. W., Dubuque (APO 115, New York, 

N. Y.) Capt., A.U.S. 

Plankers, A. G., Dubuque (APO 363 New York, 

N. Y.) Major, A.U.S. 

Quinn. E. P., Dubuque (Brentwood, L. I.) Major, A.U.S. 

Scharle, Theodore, Dubuque (APO 17570, New York, 

N. Y.) Capt., A.U.S. 

Schueller, C. J., Dubuque (APO 758, New York, 

N. Y.) 1st Lt., A.U.S. 

Sharpe, D. C., Dubuque (APO 5541, New York, 

N. Y.) Major, A.U.S. 

Smith, C. W., Dubuque (Shoemaker, Cal.) Lt., U.S.N.R. 

Steffens. L. F., Dubuque (Camp Chaffee, Ark.) ... Lt. Col., A.U.S. 

Straub, J. J., Dubuque (Corpus Christi, Texas) .... Lt., U.S.N.R. 

Ward, D. F., Dubuque (Great Lakes, 111.) . . . .Lt. Comdr., U.S.N.R. 


Idniniet County 

Clark. J. P.. Estherville (APO New York, N. Y.) .. Capt., A.U.S. 

Collins. L. E., Estherville (Camp Dodge, Iowa) A.U.S. 

Miller, O. H., Estherville (Seattle, Wash.)..Lt. Comdr., U.S.N.R. 
Fayette County 

Gallagher, J. P., Oelwein (Fleet PO, San Francisco, 

Cal.) Lt.. U.S.N.R. 

Henderson, W. B., Oelwein (St. Louis. Mo.) Lt Col., A.U.S. 

Sulzbach, J. F., Oelwein 

Walsh. W. E., Hawkeye (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R 

Floyd County 

Baltzell, W. C., Charles City (APO 2, New York, 

N. Y.) Major, A.U.S. 

Flater, N. C., Floyd (APO 360, New York, N. Y.) .Capt., A.U.S. 
Knight, R. A., Rockford (Fleet PO, San Francisco. 

Cal.) Lt., U.S.N.R. 

Mackie. D. G., Charles City (APO 493, New York, 

N. Y.) Capt., A.U.S. 

Miner, J. B„ Jr., Charles City (San Diego, Cal.) Lt., U.S.N.R. 

Tolliver, H. A., (Charles City (APO 91, New York, N. Y.) 

Capt., A.U.S. 


Franklin County 

Byers, W. L.. Sheffield (Jefferson Barracks, Mo.) 1st Lt., A.U.S. 

Hedgecock, L. E., Hampton (Camp Lejeune, 

N. Car.) Lt. Comdr., U.S.N.R. 

Randall, W. L., Hampton (Oceanside, Cal.) Lt., U.S.N.R. 

Walton, S. G.. Hampton (APO New York, N. Y.) .. .Capt., A.U.S. 

I''remont County 

Kerr, W. H.. Hamburg (Camp Phillips, Kan.) Capt., A.U.S. 

Marrs, W. D., Tabor (Ardmore, Okla.) Capt., A.U.S. 

Powell. R. A., Farragut (Great Lakes, Ill.)...Lt. (jg) , U.S.N.R. 

Wanamaker, A. R., Hamburg (APO 939, Seattle, 

Wash.) Capt., A.U.S. 

Greene County 

Cartwright, F. P., Grand Junction (APO 511, New York, 

N. Y.) Capt., A.U.S. 

Castles, W. A., Rippey (APO 958, San Francisco, Cal.) 

Major, A.U.S. 

Hanson, L. C., Jefferson (APO 728, New York, N. Y.) 

Capt., A.U.S. 

Jongewaard, A. J., Jefferson (Fleet PO, San 

Francisco, Cal.) Lt. Comdr., U.S.N.R. 

Limburg, J. I., Jr., Jefferson (APO 503, San Francisco, 

Cal.) Major, A.U.S. 

Lohr, P. E., Churdan (Hastings, Nebr.) Lt., U.S.N.R. 

Grundy County 

Cullison, R. M.. Dike (Fort Howard. Md.) Major, A.U.S. 

Rose, J. E., Grundy Center (Fleet PO, New York, 

N. Y.) Lt. Comdr., U.S.N.R. 

Hamilton County 

*Buxton 0. C., Webster City (APC) 9921, New York, 

N. Y.) 1st Lt.. A.U.S. 

Howar, B. F., Jewell (APO 514, New York, N. Y.) Major, A.U.S. 

James, D. W., Kamrar (APO 782, New York, N. Y.) 

Capt., A.U.S. 

Lewis, W. B., Webster City (APO 383, New York, 

N. Y.) Major, A.U.S. 

Mooney, F. P., Jewell (London, England) Capt., R.A.M.C. 

Paschal, G. A., Williams (Camp Barkeley, Texas) . .Capt., A.U.S. 

Patterson, R. A., Webster City (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

Ptacek, J. L., Webster City (APO 12845 G, New York, 

N. Y.) Capt., A.U.S. 

Schrader, M. A., Webster City (Topeka, Kan.).... 1st Lt., A.U.S. 

Thompson, E. D., Webster City (Biloxi. Miss.) Capt., A.U.S. 

Haneock-Winnebatro Counties 

Dolmage, G. H.. Buffalo Center (Denver, Colo.) Capt., A.U.S. 

Dulmes, A. H., Klemme (APO 782, New York, 

N. Y.) Capt., A.U.S. 

Eller, L. W., Kanawha (APO 302, New York, 

N. Y.) Capt., A.U.S. 

Irish, T. J., Forest City (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Shaw, D. F., Britt (Delhart, Tex.) Major, A.U.S. 

Thomas, C. W., Forest City (Camp Crowder, Mo.) . .Capt., A.U.S. 

Hardin County 

Burgess, A. W., Iowa Falls (Jacksonville, Fla.) Lt., U.S.N.R. 

Houlihan, F. W., Ackley (APO 860, New York, 

N. Y.) 1st Lt., A.U.S. 

Jansonius, J. W., Eldora (APO 4834, New York, 

N. Y.) Capt., A.U.S. 

Johnson, R. J., Iowa Falls (APO 514, New York, 

N. Y.) Capt, A.U.S. 

Johnson, W. A., Alden (Orlando, Fla.) Capt., A.U.S. 

Shurts, J. J., Eldora (Camp Roberts, Cal.) 1st Lt., A.U.S. 

Steenrod, E. J., Iowa Falls (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Todd, V. S., Eldora (APO 9641, San PYanclsco, Cal.) Capt., A.U.S. 

Harri.son County 

Bergstrom, A. C., Missouri Valley (Ft. Ord, Cal.) .. .Capt., A.U.S. 

Burbridge, G. E., Logan (APO 511, New York, 

N. Y.) Major, A.U.S. 

Byrnes. C. W., Dunlap (APO 980, Seattle, Wash.) . .Capt., A.U.S. 

Heise, C. A., Jr., Missouri Valley (Fleet PO, San 
Francisco, Cal.) Lt., U.S.N.R. 

Tamisiea, F. X., Missouri Valley (APO 562, New York, 

.N. Y.) Capt., A.U.S. 

Henry County 

Brown. W. B., Mount Pleasant (APO 5V1, New York, 

N. Y.) Major, A.U.S. 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


61 


Dwankowski, Carl, Mt. Pleasant (APO 511, 

New York, N. Y.) Capt., A.U.S. 

Gloecklei'. B. B., Mount Pleasant (APO 9768, New York, 

N. Y.) Capt., A.U.S. 

Hartley, B. D„ Mount Pleasant (APO 17130, New 

York, N. Y.) Capt., A.U.S. 

Megorden, W. H., Mount Pleasant (Ogden, Utah) .. Capt., A.U.S. 

Ristine, L. P., Mount Pleasant (APO 9648, New York, 

N. Y.) Major, A.U.S. 

Howard Countr 

Buresh, Abner, Lime Springs (Fleet PO, San Francisco, 

Cal.) ; Lt., U.S.N.R. 

Nierling, P. A., Cresco (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Humboldt County 

Arent, A. S., Humboldt (Stockton, Cal.) Capt., A.U.S. 

Coddington, J. H., Humboldt (Oklahoma City, Okla.) .Capt., A.U.S. 

Ida County 

Dressier, J. B., Ida Grove (APO 713, Unit 2, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Martin, J. W., Holstein (Seymour, Ind.) Capt., A.U.S. 

Iowa County 

Geiger, U. S., North English (San Diego, 

Cal.) Lt. Comdr.. U.S.N.R. 

McDaniel, J. D.. Marengo (Fort Ord, Cal.) Capt., A.U.S. 

Miller. D. F., WilliamsMrg (Fleet PO, San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

Jackson County 

Swift. F. J., Jr., Maquoketa (APO 652, New York, 

N. Y.) Major, A.U.S. 

Jasper County 

Doake, Clarke,' Newton 1st Lt., A.U.S. 

Minkel, R. M., Newton (APO New York, N. Y. ). .Major, A.U.S. 

Ritchey, S. J., Newton Lt. Col., A.U.S. 

Jellerson County 

Castell, J. W.. Fairfield (APO 9907, New York, 

N. Y.) Capt., A.U.S. 

Frey, Harry, Fairfield (Norfolk, Va.) Lt. Comdr., U.S.N.R. 

Gittler, Ludwig, Fairfield Lt. Col., A.U.S. 

Graber, H. E., Fairfield Galesburg, 111 Major, A.U.S. 

Taylor, I. C.. Fairfield (Washington, D. C.) 1st Lt., A.U.S. 

Johnson County 

Agnew, J. W., Iowa City (APO 17604, New York 
N. Y.) Capt., A.U.S. 

Albert, S. M., Iowa City (Camp White, Ore.) 1st Lt., A.U.S. 

Allen, J. H., Iowa City (Scott Field, 111.) Major, A.U.S. 

Anderson, E. N., Iowa City (APO 647, New York, 

N. Y.) Major, A.U.S. 

Boyd, E. J., Iowa City (APO 140, New York, N. Y.) .Capt., A.U.S. 

Brinkhous, K. M., Iowa City (APO 4672, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Bunge, R. G.. Iowa City (Biloxi, Miss.) 1st Lt., A.U.S. 

Callahan, G. D., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R, 

Coburn, F. E., Iowa City (Toronto, Canada) Capt., R.C.A. 

Cooper, W. K., Iowa City (Mitchell Field, N. Y.) Capt., A.U.S. 

Crowell, E. A., Iowa City (Ft. Geo. Wright, Wash.) .Capt., A.U.S. 

Diddle, A. W., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Dorner, R. A., Iowa City (APO 534, New York, 

N. Y.) Capt., A.U.S. 

Elmquist, H. S., Iowa City (San Diego, Cal.),Lt. Comdr., U.S.N.R. 

Emmons, M. B,, Iowa City (Abilene, Texas) Capt., A.U.S. 

Flax, Ellis, Iowa City (APO 5833, New York, N. Y.) 1st Lt., A.U.S. 

Flynn, J. E., Iowa City (Hot Springs, Ark.) Major, A.U.S. 

Fourt. A. S., Iowa City (APO 34, New York, 

N. Y.) Lt. Col., A.U.S. 

Francis, N. L„ Iowa City (Annapolis, Md.)....Lt. (jg) , U.S.N.R. 

Galinsky, L. J., Oakdale (Camp Crowder, Mo.) Capt., A.U.S. 

Garlinghouse, R. O., Iowa City (APO 302, New York, 

N. Y.) Major, A.U.S. 

Hardin, R. C., Iowa, City (APO 508, New York, 

N. Y.) Major, A.U.S. 

Hartung, Walter. Iowa City (Camp Carson, Colo.) . .Capt., A.U.S. 

Hessin, A. L., Iowa City (APO 452, New York, 

N. Y.) Capt., A.U.S. 

Irwin. R. L., Iowa City (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

January, L. E„ Iowa City (Pyote, Texas) Major, A.U.S. 

Kanealy, J. F., Iowa City (APO 928, San Francisco, 

Cal.) 1st LL, A.U.S. 

Keislar, H. D., Iowa City (Washington, D. C.) 1st Lt., A.U.S. 

Lage, R. H., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. U.S.N.R. 

Laubscher, J. H., Iowa City (Ft. Benning, Ga.) . . . .1st Lt., A.U.S. 

Longwell, F. H., Iowa City (APO 515, New York, 

N. Y.) Major,A.U.S. 

Moreland. F. B., Iowa City (Maxwell Field, Ala.) .. 1st Lt., A.U.S. 

Nagyfy, S. F., Iowa City (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Newman, R. W., Iowa City (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Parkin, G L,, Iowa City (Mountain Home, Idaho) 1st Lt., A.U.S. 

Paulus. E. W.. Iowa City (APO 34, New York, 

N. Y.) Lt. Col., A.U.S. 

Petersen, V. W., Iowa City (APO 689, New York, 

N, Y.) Cot., A,U.S. 

Sells, R. L., Jr., Iowa City (Palmdale, Cal.) Capt., A.U.S. 

Smith, H. F., Iowa City (New York. N. Y.) Lt. Comdr., U.S.N.R. 

Springer, E. W., Iowa City (APO 622, Miami, Fla.) 1st Lt., A.U.S. 

Stadler, H. E., Iowa City (Washington, D. C.) .... 1st Lt., A.U.S. 

Staggs, W. A., Iowa City (Camp Robinson, Ark.) . .Major, A.U.S. 

Stephens, R. L., Iowa City (Orlando, Fla.) Capt., A.U.S. 


Stump, R. B., Iowa City (Denver, Colo.) Capt.. A.U.S. 

Titus, E. L., Iowa City (Belmont, Mass.) Col., A.U.S. 

Trapasso. T. J., Iowa City (APO 520, New York, 

N. Y.) ., Capt. A.U.S. 

Trussell, R. E., Iowa City (APO 5467, San Francisco, 

Cal.) Capt., A.U.S. 

Vest, W. M., Iowa City (Menlo Park, Cal.) Capt., A.U.S. 

Ward, R. H,, Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Weatherly, H. E., Iowa City (APO 72, San Francisco, 

Cal.) Capt., A.U.S. 

Wollmann, W. W., Iowa City (Staunton, Va.) 1st Lt., A.U.S. 

Ziffren, S. E., Iowa City (Springfield Mo.) 1st Lt., A.U.S. 

.lunior Members 

Adams, M. P., Iowa City Lt, (jg), U.S.N.R, 

Ahrens, J. H., Iowa City (APO San Francisco, Cal.) ..., A.U.S. 

Ball, A. L., Iowa City (Camp Polk, La,) Major, A.U.S. 

Barrent, M. E., Iowa City (Camp Tyson, Tenn.) .. Capt., A.U.S. 
Black, N. M., Iowa City (McChord Field, Wash.) 1st Lt., A.U.S. 
Blair, J. D., Iowa City (APO San Francisco, Cal.) .Major, A.U.S. 

Boyd, R. J., Iowa City (Spokane, Wash.) Capt., A.U.S. 

Brintnall, E. S., Iowa City (Colorado Springs, 

Colo.) 1st Lt., A.U.S. 

Burr, S. P., Iowa City (APO San Francisco, Cal.) . 1st Lt., A.U.S. 
Carney, R. G., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Connole, J. F., Iowa City (Camp Bowie, Texas) .. 1st Lt., A.U.S. 
Couch, O. A., Iowa City (Camp Van Dorn, Miss.) ., 1st Lt., A.U.S. 
Decker, C. E., Iowa City (Oklahoma City, Okla.) .. 1st Lt., A.U.S. 
Donnelly, B. A., Iowa City (APO San Francisco, 

Cal.) 1st Lt., A.U.S 

Ehrenhaft, J. L., Iowa City (APO New York, 

N. Y.) 1st Lt., A.U.S. 

Englerth, F. L., Iowa City (APO San Francisco, 

Cal.) Capt., A.U.S. 

Freiberg, M., Iowa City (Jefferson Barracks, Mo.) A.U.S. 

Glassman, A. L., Iowa City (Palm Springs, Cal.) 1st Lt., A.U.S. 

Hamilton, H. E., Iowa City (Chicago, 111.) 1st Lt., A.U.S. 

Harms, G. E., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Hendricks, A. B., Iowa City (Klamath Falls, Ore.) . . . Lt., U.S.N. 

Hovis, Wm., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. (jg), U.S.N.R. 

Ide, L. W., Iowa City (Fort Warren, Wyo,) 1st Lt., A.U.S. 

Jacobs, C. A., Iowa (jlity (APO New York, N. Y.) Major, A.U.S. 
Kaplan, Nathan, Iowa City (Carlisle Bar- 
racks, Pa.) 1st Lt., A.U.S. 

Keil, P. G., Iowa City (Sioux City, Iowa) 1st Lt., A.U.S. 

Kelberg, M. R., Iowa City (Alameda, Cal.) Lt., U.S.N.R. 

Keleher, M. F., Iowa City (Great Lakes, Ill.)..Lt. (jg), U.S.N.R. 

Keohen, G. F., Iowa City (Camp Grant, HI.) Capt., A.U.S. 

Kugler, F. E., Iowa City (Fort Warren, Wyo.) Capt., A.U.S. 

Lowry, F. C., Iowa City (Sioux Falls, S. D.) 1st Lt., A.U.S. 

McCann, J. P., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

McQuiston, W. O., Iowa City (APO San Francisco, 

Cal.) Capt., A.U.S. 

Moen, B. H., Iowa City 

Moon, R. E., Iowa City (APO New York, N. Y.).,lstLt., A.U.S. 
Odell, Lester, Iowa City (Pensacola, Fla.) . . . .Lt. (jg), U.S.N.R. 
Phillips, R. M., Iowa City (San Francisco, Cal.) . .1st Lt., A.U.S. 
Pulliam, R. L., Iowa City (APO 350, New York, 

N. Y.) Major, A.U.S. 

Randall, C. G., Iowa City 

Randall, R. G., Iowa City (Waterloo, Iowa) Capt., A.U.S. 

Rosenbusch, M., Iowa City (Fort Leonard Wood, 

Mo.) 1st Lt., A.U.S. 

Russin, L. A., Iowa City (Fort Blanding, Fla.) Capt., A.U.S. 

Saar, J. L., Iowa City (APO New York, N. Y.) ... Capt., A.U.S. 

Sawtelle, W. W., Iowa City Lt., U.S.N.R. 

Schwidde, J. T., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Shand, J. A., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Shapiro, S. I., Iowa City 

Simpson, F. E., Iowa City (Camp Grant, 111.) A.U.S. 

Skewis. J. E., Iowa City (Corona, Cal.) Lt., U.S.N.R. 

Skouge, O. T., Iowa City 

Towle, R. A., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Warren, R. F., Iowa City (Santa Barbara, Cal.) A.U.S. 

Watters, V. G., Iowa City (Fort Leonard Wood, 

Mo.) 1st Lt., A.U.S. 

Wicks, W. J., Iowa City (Camp Crowder, Mo.) Capt., A.U.S. 

Williams, L. A., Iowa City (Treasure Island, Cal.) .1st Lt., A.U.S. 

Willumsen, H. C., Iowa City (Denver, Colo.) Capt., A.U.S. 

Wolkin, J., Iowa City (San Antonio, Texas) Capt., A.U.S. 

Yetter, W. L., Iowa City (APO New York, N. Y.)..Capt., A.U.S. 

Zahrt, N. E., Iowa City (Keesler Field, Miss.) Capt., A.U.S. 

Zimmerman, H. A.. Iowa City (Santa Ana, Cal.) .. 1st Lt.. A.U.S. 
Keokuk County 

Bjork. Floyd, Keota (APO 254, New York, N. Y.) . .Capt., A.U.S. 

Doyle, J. L., Sigourney (Camp Barkeley, Texas) A.U.S. 

Engelmann, A. T.. What Cheer (Camp Polk, La.) .. Capt., A.U.S. 

Graham, J. A., Gibson (Needles, Cal.) 1st Lt., A.U.S. 

Montgomery, G. E.. Keota (Antioch, Cal.) Capt., A.U.S. 

Wiley, Dudley, Hedrick (Mason City, Wash.) 

Ko.ssuth County 

Clapsaddle, D. W.. Burt (Denver, Colo.) Capt., A.U.S. 

Corbin, R. L„ Luverne (Des Moines, Iowa) Capt., A.U.S. 

Kenefick, J. N., Algona (San Diego, Cal.l..I,t. Comdr., U.S.N.R. 
Williams, R. L., Lakota (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 


Journal of Iowa Statf^ Mkdical Society 


Feliruary, 1945 




Lee County 

Ashline. G. H., Keokuk (APO 253, New York. N. Y.) Capt., A.U.S. 
Cleary. H. G.. Fort Madison (Ft. Bennine. Ga.) 

Capt., A.U.S. 

Cooper, R. E., Keokuk (APO 565, San Francisco, Cal.) Capt. A.U.S. 
Johnstone, A. A.. Keokuk (APO 942, Seattle, Wash.) . Col., A.U..S 

McKee, T. L., Keokuk (Miami Beach, Fla.) Major, A.U.S. 

Pumphrey, L. C.. Keokuk (Ft. Leonard Wood. Mo.). Major. A.U.S. 

Rankin, .1. R., Keokuk (Memphis, Tenn.) Lt., U.S.N.R. 

Richmond, A. C., Fort Madison (Treasure Island. 

Cal.) Lt. Comdr., U.S.N.R. 

StefTey, F. L., Keokuk (Fort Snelling, Minn.) 

Van Werden, B. D., Keokuk (APO 4777, New York, 

N. Y.) Capt., A.U.S. 

Younan, Thomas, Ft. Madison (APO 464, New York, 

N. Y.) Capt., A.U.S. 


Linn County 

Andre, G. R., Lisbon (APO 90, Ft. Dix, N. J.) Lt. Col., A.U.S. 

Berney, P. W., Cedar Rapids (APO 207, New York, N. 

Y.) Capt., A.U.S. 

Block, W. M., Cedar Rapids (APO 926, San Francisco, 

Cal.) Capt., A.U.S. 

Chapman, R. M., Cedar Rapids (Chicago, 111.) .Capt., A.U.S. 

Coughlan, V. H., Coggon (Fort Snelling, Minn.) A.U.S. 

Counter, W. O., Springville (APO 464, New York, 

N. Y.) Major, A.U.S. 

Downing, J. S., Cedar Rapids (APO 565, San Francisco, 

Cal.) Major, A.U.S. 

Dunn, F. C.. Cedar Rapids (Winfield, Kan.) Major, A.U.S. 

Gearhart, Merriam, Springville (APO 204, New Ybrk. 

N. Y.) Major, A.U.S. 

Gerstman, Herbert, Marion (Camp Van Dorn, Miss.) Capt., A.U.S. 

Halpin, L. J., Cedar Rapids (APO 17928, San Francisco. 

Cal Major, A.U.S. 

Hecker, J. T., Cedar Rapids (Camp Bowie, Texas) .. Capt., A.U.S. 

Jirsa, H. O., Cedar Rapids (APO 871, New York, 

N. Y.) Lt. Col., A.U.S. 

Keith, J. J., Marion (Menlo Park, Cal.) Major, A.U.S. 

Kieck, E. G., Cedar Rapids (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Kruckenberg, W. G„ Mount Vernon (Fleet PO, San 

Francisco, Cal.) Lt., U.S.N.R. 

Leedham, C. L., Springville (Camp Campbell, Ky. ) . . .Col., A.U.S. 

Locher, R. C., Cedar Rapids (Camp Gruber, Okla.) .Major, A.U.S. 

tMacDougal, R. F., Cedar Rapids (APO 9057, New York, 

N. Y.) . . Capt., A.U.S. 

McConkie, E. B., Cedar Rapids (Hines, 111.) Major, A.U.S, 

McQuiston, J. S„ Cedar Rapids (Fort Warren, 

Wyo.) Lt. Col., A.U.S. 

MefCert, C. B., Cedar Rapids (APO 403, New York, 

N. Y.) Lt. Col.. A.U.S. 

Murray, E. S., Cedar Rapids (APO 787, New York, 

N. Y.) Major, A.U.S. 

Netolicky, R. Y., Cedar Rapids (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Noble, W. C., Cedar Rapids (Camp San Luis Obispo. 

Cal.) 1st Lt., A.U.S. 

Noe. C. A., Cedar Rapids (Hot Springs, Ark.) ... .Major, A.U.S. 

Parke. John, Cedar Rapids Major, A.U.S. 

Proctor, R. D., Cedar Rapids (Corpus Christi, 

Texas) Comdr., U.S.N.R. 

Redmond, J, J., Cedar Rapids (APO 813, New York, 

N. Y,) Major, A.U.S. 

Rieniets, J. H., Cedar Rapids (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Sedlacek, L. B., Cedar Rapids (APO 244, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Smrha, J. A., Cedar Rapids (APO 922, San Fran- 
cisco. Cal.) Capt., A.U.S. 

Stansbury, J. R., Cedar Rapids (Fort Lewis, 

Wash.) ...Capt., A.U.S. 

Stark, C. H., Cedar Rapids (Denver, Colo.) Capt., A.U.S. 

Sulek, A. E., Cedar Rapids (APO 244, San Fran- 
cisco, Cal.) Major, A.U.S. 

Woodhouse, K. W., Cedar Rapids (APO 519, New York, 

N. Y.) Lt. Col., A.U.S. 

Wray, R. M., Cedar Rapids (APO 958, San Francisco, 

Cal.) Major, A.U.S. 

Yavorsky, W. D., Cedar Rapids (Jacksonville, Fla.) 

Lt. Comdr., U.S.N. 


Lonisa County 

DeYarman, K. T., Morning Sun (San Antonio, 

Texas) Capt., A.U.S. 

Tandy, R. W., Morning Sun (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Luca.s County 

Lister, K. E., Chariton (Fort Snelling, Minn.) A.U.S. 

Lyon County 

Cook, S. H., Rock Rapids (Memphis, Tenn.) Major, A.U.S. 

{Corcoran, T. E., Rock Rapids (Am, P,O.W. 3040, Oflag 64, 

Germany) Capt,, A.U,S. 

Moriarty, J, F., Rock Rapids (APO 464, New York, 

N. Y.) Capt., A.U,S, 

Madison County 

Boden, H. N„ Truro (Fresno, Cal.) 

Chesnut, P. F., Winterset (Camp Gruber, Okla.) . . . .Capt., A.U.S. 
Veltman, J. F.. Winterset (AP(3 957, San Francisco, 

Cal.) Capt., A.U.S. 

Wicks, R. L., Winterset (APO 637, New York, N. Y.) 

Lt. Col., A.U.S. 


Mahaska County 

Bennett, G. W., Oskaloosa (APO 9641, San Francisco, 

Cal.) Major, A.U.S. 

Bos, H. C., Oskaloosa Major, A.U.S. 

Campbell, W. V., Oskaloosa (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Clark. G. H., Oskaloosa (Mare Island, Cal.) . .Lt. Comdr., U.S.N.R. 

Greenlee. M. R., Oskaloosa (Port Hueneme. 

Cal. ) Lt. Comdr., U. S.N.R. 

Lemon, K. M., Oskaloosa (APO 637, New York, 

N. Y.) Capt., A.U.S. 

Zager, L. L., Oskaloosa (APO 436, New York, 

N. Y.) Capt., A.U.S. 

Marion County 

Elliott, V. J., Knoxville (APO 558, New York. 

N. Y.) Major. A.U.S. 

Mater, D. A.. Knoxville (Lincoln, Neb.) Major, A.U.S. 

Ralston, F. P.. Knoxville (Indio, Cal.) Capt., A.U.S. 

Schiek. C. M., Knoxville Lt. Comdr., U.S.N.R. 

Schroeder, M. C., Pella (Gamp Livingston, La.) .... Capt., A.U.S. 

Williams, D. B., Knoxville Capt., A.U.S. 

Marshall County 

Carpenter, R. C., Marshalltown (APO 678 New York, 

N. Y.) Capt., A.U.S. 

Marble, E. J., Marshalltown (Fleet PO, Can Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Marble, W. P., Marshalltown (Colorado Springs, 

Colo.) Major, A.U.S. 

Meyer, M. G., Marshalltown (APO 513, New York, 

N. Y.) Major, A.U.S. 

Noonan, J. J., Marshalltown (Fort Jackson, 

S. Car.) Lt. Col., A.U.S. 

Phelps, R. E., State Center (APO 7, San Francisco, 

Cal.) Capt., A.U.S. 

Sinning, J E., Melbourne (Camp Haan, Cal.) Capt., A.U.S. 

Smith, E. M., State Center (APO 620, New York, 

N. Y.) LL Col., A.U.S. 

Stegman, J. J., Marshalltown (APD 520, New York, 

N. Y.) Major, A.U.S. 

Wells, R. C., Marshalltown (Gowen Field, Idaho) . . . .Capt., A.U.S. 

Wolfe, O. D., Marshalltown (APO 937, Seattle 
W ash. ) Capt., A.U.S. 

Wolfe, R. M., Marshalltown (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Mills County 

DeYoung, W. A., Glenwood (APO 228, New York, 

N. Y.) Capt., A.U.S. 

Kuitert, J. H., Glenwood (St. Cloud, Minn.) Major, A.U.S. 

Magaret, E. C., Glenwood (APO 973, Minneapolis, 

Minn.) Capt., A.U.S. 

Shonka, T. E., Malvern (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Jliteliell County 

Culbertson, R. A., St. Ansgar (APO 17928, San 

Francisco, Cal.) Lt. Col., A.U.S. 

Moore, E. E., Osage (APO 591, New York, N. Y.) .Major, A.U.S. 

Owen, W. E., Osage (Fleet PO, San Francisco, Cal.) 

Lt. (jg), U.S.N.R. 

Walker, T. G., Riceville (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 


> Monona County 

,Mmer, L. E., Moorhead (Fort Knox, Ky.) Capt., A.U.S. 

Anderson, S. N., Onawa (Great Lakes, 111.) Lt., U.S.N.R. 

Ganzhorn, H. L., Mapleton (APO 72, San Francisco. 

Cal.) Capt., A.U.S. 

Gaukel, L. A., Onawa (Fort Riley, Kan.) Capt., A.U.S. 

tHarlan, M. E., Onawa (Fleet PO, San Francisco, 

Cal.) Lt. (jg), U.S.N.R. 

Stauch. M. O., Whiting (Port Lewis. Wash.) Major, A.U.S. 

Wainwright, M. T., Mapleton (APO 17508, New York, 

N. Y.) Capt., A.U.S. 

Wolpert, P. L., Onawa (Camp Atterbury, Ind.) .... Capt., A.U.S. 

Monroe County 

Gilliland, C. H., Albia (Quonset Point, R. I.) Lt., U.S.N.R. 

Heimann, V. R., Albia (Camp Maxey, Texas) Capt., A.U.S. 

Richter, H. J., Albia (Waco, Texas) Major, A.U.S. 

Smith, R. A., Albia (New Cumberland, Pa.) Capt.. A.U.S. 

Montgomery County 

Bastron, H. C., Red Oak (APO 951, San Francisco, 

Cal.) Major. A.U.S. 

Hansen, F. A., Red Oak (Clarksville, Ark.) Lt., U.S.N.R. 

Nelson, C. C., Red Oak (Fleet PO, San Francisco, 

Cal.) Lt.. U.S.N.R. 

Panzer, E. J. C., Stanton (Fleet PO, San Francisco, 

Cal.) Lt. (jg), U.S.N.R. 

Rost, G. S., Red Oak (Chickasha, Okla.) Capt., A.U.S. 

Sorensen, E. M., Red Oak (Jefferson Barracks, 

Mo.) Capt., A.U.S. 


Museatine County 

Ady, A. E., West Liberty (Pensacola, Fla.) Comdr., U.S.N.R. 

Asthalter, R. W., Muscatine (Fort Meade, Md.) ... 1st Lt., A.U.S. 

Carlson, E. H., Muscatine (Milwaukee, Wis.) Capt., A.U.S. 

Goad, R. R., Muscatine (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

Kimball, J. E., Jr., West Liberty (Sioux City, Iowa) .Major, A.U.S. 
Lindley, E. L., Muscatine (APO 6, San Francisco, 

Cal.) Capt., A.U.S. 

Muhs, E. 0., Muscatine (APO 578, New York, 

N. Y.) Major, A.U.S. 

Norem, Walter, Muscatine (APO, Miami, Fla.) CapL, A.U.S. 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


63 


Robertson, T. A., West Liberty (APO 119, New York, 

N. Y.) Capt., A.U.S. 

Sywassink, G. A., Muscatine (APO 488-"Y” 

Forces, New York, N. Y.) Lt. Col., A.U.S. 

Whitmer, L. H., Wilton Junction (Fort Sill, 

Okla.) Lt. Col., A.U.S. 

O’Brien County 

Getty, E. B., Primghar (APO 176, New York, 

N. Y.) Capt., A.U.S. 

Hayne, W. W.. Paullina (APO 638, New York, 

N. Y.) Capt., A.U.S. 

Moen, S. T., Hartley (APO 689, New York, 

N. Y.) Major, A.U.S. 

Myers, K. W., Sheldon (Watertown, S. Dak.) 1st Lt., A.U.S. 

Osceola Connty 

Kuntz, G. S., Sibley (APO 34, New York, N. Y.) Capt., A.U.S. 

Page Connty 

Barnes, C. A., Shenandoah (Fort Bragg, N. C.) ... .Capt., A.U.S. 

Blackman, Nathan, Clarinda (Ft. Leavenworth, 

Kan.) Capt., A.U.S. 

Bossingham, E. N., Clarinda (Fort Ord, Cal.) Major, A.U.S. 

Bunch, H. McK., Shenandoah (San Diego, 

Cal.) Lt. Comdr.. U.S.N.R 

Burdick. F. D., Shenandoah Capt., A.U.S. 

Burnett, F. K.. Clarinda (Denver, Colo.) Major, A.U.S. 

Rausch, G. R., Clarinda (Sioux City, Iowa) Capt., A.U.S. 

Savage, L. W.. Shenandoah (Fort Meade, Md.) .... 1st Lt., A.U.S. 


Palo Alto County 

Davey, W. P.. Emmetsburg (Fleet PO, San 

Francisco, Cal.) a .. .Lt., U.S.N.R. 

Plymouth County 

Bowers. C. V., LeMars (APO New York, N. Y.) . .1st Lt., A.U.S. 

Fisch, R. J., LeMars (Denver, Colo.) Capt., A.U.S. 

Foss, R. H„ Remsen (Salt Lake City, Utah) Capt., A.U.S. 

Wolfson, Harold, Kingsley (Fort Lewis, Wash.) ... .Capt., A.U.S. 

Pocahontas County 

Blair, F. L., Jr., Fonda (San Antonio, Texas) Lt., U.S.N.R. 

Herrick, T. G., Gilmore City (APO 9875, New York, 

N. Y.) .. Capt., A.U.S. 

Larson, J. B., Laurens (APO 720, San Francisco, 

Cal.) Capt., A.U.S. 

Leserman, L. K., Rolfe (APO 502, San Francisco, 

Cal.) Capt., A.U.S. 

Patterson, A. W., Fonda (Des Moines, Iowa) Capt., A.U.S. 


Polk County 

Abbott, W. D., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Anderson, N. B., Des Moines (APO 667, New York, 

N. Y.) Lt. Col., A.U.S 

Angell, C. A., Des Moines (Ft. Bragg, N. Car.) ... .Capt., A.U.S. 

Anspach, R. S., Mitchellville (APO 528, New York,' 

N. Y.) Lt. Col., A.U.S. 

Barner, J. L., Des Moines (Atlanta, Ga.) Major, A.U.S. 

Barnes, B. C., Des Moines (Ogden, Utah) Major, A.U.S. 

Bates, M. T., Des Moines (Corona, Cal.) .... Lt. Comdr., U.S.N.R. 

Bender, H. R., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Bond, T. A., Des Moines (Shoemaker, Cal.) Lt., U.S.N.R. 

Bone, H. C., Des Moines (Arlington, Cal.) Major, A.U.S. 

Brown, A. W„ Des Moines (APO 5934, New York, 

N. Y.) Capt., A.U.S. 

Bruner, J. M., Des Moines (Camp Barkeley, Texas) . . Major, A.U.S. 

Bruns, P. D., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

(Burgeson, F. M., Des Moines (Gefangenennummer 1480, 
Lager-Bezeichnung : Kriegsgef-Offizierlager XXI B, 
Deutschland [Allemagne]) Capt., A.U.S. 

Caldwell, J. W., Des Moines, (Patricia Bay, 

British Columbia, Canada) Flight Lt., R.C. A. F. 

Chambers, J. W., Des Moines (APO 648, New York, 

N. Y.) Capt,, A.U.S. 

Chase, W. B., Jr., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Clark, G. E., Jr., Des Moines (APO 520, New York, 

N. Y.) Capt., A.U.S. 

Connell, J. R., Des Moines (Phoenixville, Pa.) Major, A.U.S. 

Corn, H. H., Des Moines (Douglas, Wyo.) Capt., A.U.S. 

Coughlan, D. W., Des Moines (APO 689, New York, 

N. Y.) Capt., A.U.S. 

Crowley, D. F., Jr., Des Moines (Presque Isle, Me.) . .Capt., A.U.S. 

Crowley. F. A., Des Moines (APO 783, New York. 

N. Y.) Capt., A.U.S. 

DeCicco, Ralph, Des Moines (APO 952, San Francisco, 

Cal.) Capt., A.U.S. 

Decker, H. G., Des Moines (Long Beach, 

Cal.) Lt. Comdr., U.S.N.R. 

Downing, A. H., Des Moines (Ft. Snelling, Minn.) .1st Lt.. A.U.S. 

Dushkin, M. A., Des Moines (APO 689, New York, 

N. Y.) Lt. Col., A.U.S. 

Elliott, O. A., Des Moines (Pecos, Texas) Capt., A.U.S. 

Ellis, H. G., Des Moines (APO 710, San Francisco, 

Cal.) Capt., A.U.S. 

Ervin, L. J., Des Moines (Lubbock, Texas) Lt. Col., A.U.S, 

Fleck, W. L., Des Moines (Ft. Howard, Md.) Lt. Col., A.U.S. 

Fried. David, Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Fracasse, John, Des Moines 1st Lt., A.U.S. 

George, E. M., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Gerchek, E. W., Des Moines 


Gibson, D. N„ Des Moines (APO 322, Unit I, San 
Francisco, Cal.) Major, A.U.S. 

Glomset, D. A., Des Moines (APO 9826 New York. 

N. Y.) Capt., A.U.S. 

Goldberg, Louie, Des Moines (APO 926, San Francisco, 

Cal.) Capt., A.U.S. 

Gordon, A. M., Des Moines (APO 600, New York, 

N. Y.) Capt.. A.U.S. 

Graeber, F. O., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt.. U.S.N.R. 

Greek, L. M„ Des Moines (APO 512, New York, 

N. Y.) Capt., A.U.S. 

Gurau, H. H., Des Moines (Malden, Mo.) Capt., A.U.S. 

Haines, D. J., Des Moines (APO 453, San Francisco, 

Cal. I Capt., A.U.S. 

Harris, D. D., Des Moines (Gulfport, Miss.) . .Lt. Comdr., U.S.N.R. 

Harris. H. L., Des Moines (Salina, Kan.) 1st Lt., A.U.S. 

Hess, John, Jr., Des Moines 1st Lt., A.U.S. 

James, A. D., Des Moines (Fort Eustis, Va.) .. .Comdr., U.S.N.R, 

Johnston, C. H., Des Moines (Randolph Field, 

Texas) Lt. Col., A.U.S. 

Kast, D. H,. Des Moines (Fort Stevens, Ore.) Capt., A.U.S. 

Kelley, E. J., Des Moines (Columbus, Ohio) . .Lt. Comdr., U.S.N.R. 

Kelly, D H.. Des Moines (Denver, Colo.) Lt. Col.. A.U.S. 

Kirch, W. A. W., Des Moines (Astoria, Ore.) .Lt. Comdr., U.S.N.R. 

Klocksiem, H. L., Des Moines (APO New York, 

N. Y.) Capt., A.U.S. 

Kottke, E. E., Des Moines (Temple, Texas) Capt., A.U.S. 

Landis, S. N., Des Moines (West Palm Beach, 

Fla.) 1st Lt., A.U.S. 

La Tona, Salvatore, Des Moines 1st Lt., A.U.S. 

Lederman, .lames. Des Moines 1st Lt., R.C. A. 

Lehman, E. W., Des Moines (APO 711, 

San Francisco. Cal.) Major, A.U.S. 

Losh, C. W., Jr., Des Moines (APO 209, New York, 

N. Y.) 1st Lt., A.U.S. 

Lovejoy, E. P., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr.. U.S.N.R. 

Maloney. P. J., Des Moines (Fort Lewis, Wash.) 1st Lt., A.U.S. 

Marquis, G. S., Des Moines (Brooklyn, N. Y.) .Lt. Comdr., U.S.N.R. 

Martin, L. E.. Des Moines (Helena, Ark.) 1st Lt., A.U.S. 

Matheson, J. H., Des Moines (San Leandro, 

Cal.) Lt. Comdr., U.S.N.R. 

Mauritz, E. L., Des Moines (APO 763, New York, 

N. Y.) Capt., A.U.S. 

McCoy, H. J., Des Moines (Iowa City, Iowa) .. .Comdr., U.S.N.R. 

McDonald, D. J., Des Moines (APO 339, New York, 

N. Y.) Major, A.U.S. 

McNamee, J. H., Des Moines (San Diego. 

Cal.) Lt. Comdr., U.S.N.R. 

Mencher, E. W., Des Moines 1st Lt., A.U.S. 

Merkel, B. M., Des Moines (APO 520, New York, 

N. Y.) Major, A.U.S. 

Montgomery, S. A., Des Moines (Carlisle Barracks, 

Pa.) Capt., A.U.S. 

Morden, R. P., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S 

Mumma, C. S., Des Moines (Los .4ngeles, Cal.) ... .Major, A.U.S. 

Murphy, J. H., Des Moines (Fleet PO, San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

Nelson, A. L.. Des Moines (Camp Livingston, La.) Major. A.U.S. 

Noun, L. J., Des Moines (Camp Peary, Va.) Lt., U.S.N.R. 

Noun, M. H., Des Moines (APO 228, New York, 

N. Y.) Major, A.U.S 

Nourse, M. H., Des Moines (Fleet PO, New York, 

N. Y.) Lt.,U.S.N. 

Patton, B. W., Des Moines (Camp Robinson, 

Ark.) 1st Lt., A.U.S. 

Pearlman, L. R., Des Moines (Battle Creek, Mich.) . .Major, A.U.S. 

Peisen, C. J., Des Moines (APO 165, New York, 

N. Y.) .' Capt., A.U.S. 

Penn, E. C„ West Des Moines (APO 660, New York, 

N. Y.) Capt., A.U.S, 

Pfeiffer, E. P., Des Moines (APO 711, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Phillips, A. B., Des Moines (Corona, Cal.) Lt., U.S.N.R. 

Porter, R. J., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Powell, L. D., Des Moines (Oceanside, Cal.) Capt.. U.S.N.R. 

Pratt, E. B., Des Moines (APO New York, N. Y.) . .Major, A.U.S. 

Priestley, J. B., Des Moines (Camp Crowder, Mo.) .Lt. Col., A.U.S. 

Purdy. W. O., Des Moines (APO 5935, New York, 

N. Y.) Capt., A.U.S. 

Riegelman, R. H., Des Moines (APO 559, New York, 

N. Y.) Major. A.U.S. 

Robinson, V. C., Des Moines (Gulfport, Miss.) Major, A.U.S. 

Rotkow, M. J., Des Moines (Ft. Benj. Harrison, 

Ind.) ' Capt., A.U.S. 

Schaeferle, M. J.. Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Schlaser, V. L., Des Moines (Fleet PO, San Francsico. 

Cal.) Lt.. U.S.N. 

Shepherd, L. K., Des Moines (APO New York, 

N. Y.) Major, A.U.S. 

Shiffler, H. K., Des Moines (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Singer, P. L., Des Moines (Camp Grant, 111.) .... 1st Lt., A.U.S. 

Skultety, J. A., Des Moines (New Orleans, La.) 

P. A. Surg., U.S.P.H.S. 

Smead. H. H., Des Moines (APO 141, New York, 

N. Y.) Capt., A.U.S. 

Smith, H. J.. Des Moines (Chicago, 111.) Lt.. U.S.N.R. 


64 


jouuNAL OF Iowa Statf Medical Society 


I'eliniary, 1945 


Smiih. R. T.. Des Moines (APO 713, Unit I, San Francisco, 

Cal. I Capt., A.U.S. 

•Snodcrass, R. W.. Des Moines (APO 9528, New York, 

N. Y.) Capt., A.U.S. 

Snyder, G. E., Grimes (APO 2C4, San Francisco, 

Cal.) . Major. A.U.S. 

Sohm, H. A., Des Moines Lt. Comdr., U.S.N.R. 

Sorensen, R, M., Des Moines (Topeka, Kan. i .. Major, U.S.P.H.S. 

Springer, F. A., Des Moines (Treasure Island, 

Cal.) Lt. Comdr., U.S.N.R. 

Stearns, A. B., Des Moines (Denver. Colo.) Major, A.U.S. 

Stickler. Robert, Des Moines (APO New York, 

N. Y.) Major. A.U.S. 

Stitt, P. L., Des Moines (Seattle, Wash.) Lt. (jg), U.S.N.R. 

Throckmorton, J. F., Des Moines (APO 339, New York, 

N. Y.) Major, A.U.S. 

Toubes, A. A., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Turner. H. V., Des Moines (Camp Fannin, Texas) . . .Capt., A.U.S. 

Updegraff, Thomas, Des Moines (Spokane, Wash.) . 1st Lt., A.U.S. 

Van Hale, L. A., Des Moines (APO 515, New York, 

N. Y.) Capt., A.U.S. 

Vaubel, E. K., Des Moines (Washington, D. C.) .... Capt., A.U.S. 

Wagner, E. C., Des Moines (Washington, D. C.) .. 1st Lt., A.U.S. 

Willett, W. M., Des Moines (APO 507, New York, 

N. Y.) Capt., A.U.S. 

Wirtz, D. C., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Zarchy, A. C.. Des Moines (Camp Cooke. Cal.) .... Capt., A.U.S. 


Pottawattamie County , 

tBeaumont, F. H., Council Bluffs (APO 34, New York, 

N. Y.) Major. A.JJ.S. 

Collins, R. M., Council Bluffs (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Dean, A. M., Council Bluffs (Pensacola, Fla.) ... Comdr., U.S.N.R. 

Edwards, C. V., Council Bluffs (Pensacola, Fla.) 

Lt. Comdr., U.S.N.R. 

Floersch, E. B., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Hennessy, J. D., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Jensen, A. L., Council Bluffs (Temple, Texas) ... .Lt. Col., A.U.S. 

Kick, G. J., Council Bluffs (Fleet PO, San Diego, 

Cal.) Lt., U.S.N.R. 

Kurth, C. J., Council Bluffs (Camp Crowder, Mo.). .Capt., A.U.S. 

Limbert, E. M., Council Bluffs (APO 403, New York, 

N. Y.) Major, A.U.S. 

Maiden, S. D., Council Bluffs (Camp Hood, Texas) . .Major, A.U.S. 

Martin, L. R., Council Bluffs (San Francisco, Cal.) . .Capt., A.U.S. 

Mathiasen, H. W., Neola (Alexandria, La.) Capt., A.U.S. 

Moskovitz, J. M., Council Bluffs (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Rosenfeld, R. T., Council Bluffs (Staten Island, 

N. Y,) Capt., A.U.S. 

Standeven, W., Oakland (Colorado Springs, Colo.) . .Capt., A.U.S. 

Sternhill, Isaac, Council Bluffs (Springfield, Mo.) .. .Capt., A.U.S. 

Tinley, R. E., Council Bluffs (APO 600, New York, 

N. Y.) Major, A.U.S. 

Treynor, J. V., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Comdr., U.S.N.R. 

West, A. G„ Council Bluffs (APO 230, New York, 

N. Y.) Capt,, A.U.S. 

Wieseler, R. J., Avoca (McChord Field, Wash.) A.U.S. 

Wurl, O. A., Council Bluffs (APO 887, New York, 

N. Y.) Major, A.U.S. 


Pow'e.shiek County 

Brobyn, T. E., Grinnell (Camp Swift, Texas) Major, A.U.S. 

Hickerson, L. C., Brooklyn (APO 559, New York, 

N, Y.) Capt., A.U.S. 

Korfmacher, E. S., Grinnell (APO 92, San Francisco, 

Cal.) Capt., A.U.S. 

Niemann, T. V., Brooklyn (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Parish, J. R., Grinnell (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Somers, P. E., Grinnell (St. Louis, Mo.) 1st Lt., A.U.S. 

Rin^gtold County 

Seaman, C. L., Mount Ayr (Fort Smith, Ark. ).... Major, A.U.S. 

Sac County 

Bassett, G. H., Sac City ( Metairie, La.) Lt. Comdr., U.S.N.R. 

Deters, D. C., Schaller (APO 34, New York, N. Y Capt., A.U.S. 

Evans, W. L, Sac City (APO 9212, New York, 

N. Y.) Capt., A.U.S. 

Klocksiem, R. G., Odebolt (Oceanside, Cal.) Lt., U.S.N.R. 

Neu, H. N., Sac City (APO 708, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Scott County 

fBaker, R. W.. Davenport (APO 511, New York, 

N. Y.l Capt., A.U.S. 

Balzer, W. J., Davenport (APO 569, New York, 

N. Y.) Capt., A.U.S. 

Bishop. J. F., Davenport (Camp Wheeler, Ga.) .... Capt., A.U.S. 

Block, L. A., Davenport (Cambridge, Ohio) Major, A.U.S. 

Boden, W. C., Davenport (APO 3760, New York, 

N. Y.) Capt., A.U.S. 

Boyer, U. S., Davenport (Bock Island, III.) Lt. Col., A.U.S. 

Brown, M. J., Davenport (APO 5934, New York, 

N. Y.) Major, A.U.S. 

Carey, E. T., Davenport (APO 928, San Francisco, 

Cal.) .1st Lt., A.U.S. 


Christiansen. C. C., Dixon (APO 961, San Fran- 
cisco, Cal. I Capt., A.U.S. 

Coleman, Tom, Davenport (APO 230, New York. 

N. Y.) Capt., A.U.S. 

Cummins, G. M., Jr., Davenport (Fort Custer, 

Mich.) Capt.. A.U.S. 

Decker. C. E., Davenport (APO 321, San Francisco, 

Cal.) Major, A.U.S. 

Evans, H. J., Davenport (Daytona Beach, Fla.) .... Capt., A.U.S. 

Gibson, P. E., Davenport (Palm Springs, Cal.) .... Major, A.U.S. 

Goenne, Wm., Jr., Davenport (APO 91, New York, 

N. Y.) Capt., A.U.S. 

Hurevitz, II. M.. Davenport (APO 370, New York, 

N. Y.) Major, A.U.S. 

Hurteau, Everett, Davenport (APO 647, New York, 

N. Y.) Capt., A.U.S. 

Hurteau. W. W., Davenport (Camp Barkeley, 

Texas) Major, A.U.S. 

Kimberly. L. W., Davenport (Hines, 111.) Capt., A.U.S. 

Krakauer, Max, Davenport (APO 17366, New York, 

N. Y.) Capt., A.U.S. 

Kuhl, A. B., Jr., Davenport (Ft. Meade, Md.) 1st Lt., A.U.S. 

LaDage, L. H., Davenport (APO 229, New York, 

N. Y.) Major. A.U.S. 

Lorfeld, G. W.. Davenport (Columbus, Ohio) Capt., A.U.S. 

Marker, J. L., Davenport (Auburn, Cal.) Col., M.R.C. 

McMeans, T. W., Davenport (APO 557, New York, 

N. Y.) Capt., A.U.S. 

Neufeld, R. J., Davenport (APO 565, Unit I, San Francisco, 

Cal. I Capt., A.U.S. 

Perkins, R. M., Davenport (Carlisle Barracks, 

Pa.) 1st Lt., A.U.S. 

Sheeler, I. H., Davenport (APO 350, New York, 

N. Y.) Capt., A.U.S. 

Shorey, J. R., Davenport (APO 204, New York, 

N. Y.) Capt., A.U.S. 

Smazal, S. F., Davenport (APO 230, New York, 


N. Y.l Capt., A.U.S. 

Sorenson, A. C., Davenport (Oakland, Cal.) ... Comdr., U.S.N.R. 
Sunderbruch, J. H., Davenport (APO 322, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Weinberg, H. B.. Davenport (APO 5587, San Francisco, 

Cal.) Major, A.U.S. 

Zukerman, C. M., Bettendorf (Chicago, 111.) Capt., A.U.S. 


Slielby County 

Bisgard, C. V., Harlan (Farragut, Idaho) .. .Lt. Comdr., U.S.N.R. 

Griffith, W. O., Shelby (APO 9490, New York, 

N. Y.) Capt., A.U.S. 

McGowan, J. P., Harlan (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Sioux County 

Gleysteen, R. B., Alton (Portsmouth. Va.)....Lt. Comdr., U.S.N. 

Grossmann, E. B., Orange City (APO 572, New York, 

N. Y.) Capt., A.U.S. 

Larson, M. O., Hawarden (APO 562, New York, 

N. Y.) Lt. Col., A.U.S. 

Oelrich, A. M., Hull (APO New York, N. Y. )... .1st Lt., A.U.S. 

Oelrich, C. D., Sioux Center (Buckley Field, Colo.) . 1st Lt., A.U.S. 

Story County 

Conner, J. D., Nevada (APO 708, San Francisco, 

Cal.) Capt., A.U.S. 

Fellows, J. G., Ames (APO 451, New York, N. Y.) . .Major, A.U.S. 

Lekwa, A. H., Story City (San Diego, Cal.) . .Lt. Comdr., U.S.N.R. 

McFarland. (3. E., Jr., Ames (San Pedro, Cal.) .. .Lt., U.S.N.R. 

McFarland, J. E., Ames (Seattle, Wash.) . . . .Lt. Comdr., U.S.N.R. 

Rosebrook, L. E., Ames (APO 433, New York 

N. Y.) Major, A.U.S. 

Sperow, W. B., (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Thorburn, O. L., Ames (Alamagordo, N. Mex.) ... .Major, A.U.S. 

Wall, David, Ames (Ft. Dix. N. J.) 1st Lt., A.U.S. 


Tniiia County 

Bezman, H. S., Traer (APO 9875, New York, N. Y.) Capt., A.U.S. 

Boiler, CJ. C., Traer (Ft. Riley, Kansas) Capt., A.U.S. 

Dobias, S. G., Chelsea (San fVancisco, Cal.) Capt., A.U.S. 

Havlik, A. J., Tama (San Diego, Cal.) Lt., U.S.N. R. 

Schaeferle, L. G., Gladbrook (Fort Leonard Wood, Mo.) 

Standefer. J. M., Tama (Des Moines, Iowa) Lt., U.S.N.R. 

Taylor County 

Hardin, J. F., Bedford (APO 952, San Francisco, 

Cal.) 1st Lt., A.U.S. 

Union County 

Beatty, H. G., Creston (New Orleans, La.) 1st Lt., A.U.S. 

Paragas, M. B., Creston (APO 442, San Francisco, 

Cal.) Capt., A.U.S. 

Ryan, C. J., Creston (Scribner, Neb.) Capt., A.U.S. 

Wapello County 

Brentan, Emanuel, Ottumwa (APO 252, New York, 

N. Y.) 1st Lt., A.U.S. 

Brody, Sidney, Ottumwa Lt. Col., A.U.S. 

Gilfillan, C. D. N., Eldon (Battle Creek, Mich.) . . . .Capt., A.U.S. 
Hughes, R. 0., Ottumwa (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Moore, G. C., Ottumwa (APO 17508, New York, 

N. Y.) Capt.. A.U.S. 

Nelson, F. L., Jr., Ottumwa Capt., A.U.S. 

Prewitt, L. H., Ottumwa (Atlantic City, N. J.) Major, A.U.S. 

Selman, R. J., Ottumwa (El Paso, Texas) Col., A.U.S. 

Strnble. G. C., Ottumwa (Fort Harrison, Ind.) — .Lt. Col., A.U.S. 

Whitenouse, W. N., Ottumwa (San Diego, 

(5al.) Lt. Comdr., U.S.N.R. 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


65 


Warren County 


Fullgrrabe, E. A., Indianola (Fleet PO, New York, 

N. Y.) •• Lt., U.S.N.K. 

Hoffman, G. R., Lacona (Camp San Louis Obispo, 

Cal.) Capt., A.U.S. 

Shaw, E. E., Indianola (APO 834, New Orlean.s, 

La.) Capt., A.U.S. 

Trueblood, C. A.. Indianola (APO 350, New York, 

N. Y.) Capt., A.U.S. 


Wa.shiiiKton County 

Boice, C. L., Washington (Fleet PO. San Francisco, 

Cal.) Lt., U.S.N. 

Droz, A. K., Washington (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N. R. 

Mast, T, M., Washington (Long Beach, 

Cal.) Lt. Comdr., U.S.N. R. 

Miller. J. R.. Wellman (APO New York. N. Y.) 1st. Lt., A.U.S. 

Stutsman, R. E, Washington (Patuxent River, 

Md.) Lt.,U.S.N.R. 

Ware, S. C., Kalona (APO 218, New York, N. Y.) . .Capt., A.U.S. 
Wayne County 

Hyatt, C. N„ Jr., Humeston (APO 6, San Francisco, 

■ Cal.) Capt., A.U.S. 


Webster County 

Baker, C. J., Fort Dodge (APO New York, N. Y.). .Major, A.U.S. 

Burch, E. S., Dayton (Palm Springs, Cal.) Capt., A.U.S. 

Burleson, M. W., Fort Dodge (Pasadena, Cal.) Capt., A.U.S. 

Coughlan, C. H., Fort Dodge (Fort Des Moines, 

Iowa) Major, i ..U.S. 

Dawson, E. B., Fort Dodge (San Diego, 

Cal.) Lt. Comdr., U.S.N. R. 

Glesne, O. N., Ft. Dodge (New River, N. C.).Lt. Comdr., U.S.N.R. 

Joyner, N. M., Fort Dodge (Minneapolis, Minn.) A.U.S. 

Kluever, H. C., Fort Dodge (St. Louis, Mo.) 

Lt. Comdr., U.S.N.R. 

Larsen, H. T., Fort Dodge (Pensacola, Fla.) Lt., U.S.N.R. 

Shrader, J. C., Fort Dodge (APO 758, New York, 

N. Y.) Lt. Col., A.U.S. 

‘Thatcher, O. D., Fort Dodge (APO 634, New York, 

N. Y.) Capt., A.U.S. 

Thatcher, W. C., Fort Dodge (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Van Patten, E. M., Ft. Dodge (El Paso, Texas) .... Capt., A.U.S. 

Winneshiek County 

Fritchen, A. F., Decorah (Mare Island, Cal.) . .Comdr., U.S.N.R. 

Hospodarsky, L. J., Ridgeway (APO 638, New York, 

N. Y.) Lt. Col., A.U.S. 

Howard, W. H., Decorah Capt., A.U.S. 

Larson, L. K, Decorah (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Svendsen, R. N., Decorah (San Diego. Cal.)...Lt. (jg) . U.S.N.R. 

Van Besien, G. J., Decorah (Springfield, Mo.) ... .Capt., A.U.S. 


Woodbury County 

Bettler, P. L., Sioux City (APO 235, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Blackstone, M. A., Sioux City (Camp Stoneman, 

Cal.) Capt., A.U.S. 

Boe, Henry, Sioux City (Fort Snelling, Minn.) Capt., A.U.S. 

Burroughs, H. H., Sioux City (Fleet PO, San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

JCmeyla, P. M., Sioux City (P.O.W., c/o Japanese 

Red Cross, Tokyo, Japan) Capt., A.U.S. 

Cowan, J. A., Sioux City (Oklahoma Ci£y, 

Okla.) Major, U.S.P.H.S. 

Crowder, R. E., Sioux City (Kansas City, 

Mo.) Lt. Comdr., U.S.N.R. 

Dimsdale, L. J., Sioux City (Clinton, Iowa) Capt., A.U.S. 

Down, H. I., Sioux City (APO 758, New York, 

N. Y.) ; Lt. Col., A.U.S. 

Elson, V. J., Danbury (APO 9875, New York, 

N. Y.) Capt., A.U.S. 

Frank, L. J., Sioux City (Vallejo, Cal.) Comdr., U.S.N.R. 

Graham, J. W., Sioux (jity (Pensacola, Fla.) Lt. Comdr., U.S.N.R. 

Grossman, M. D., Sioux City (APO 33, San Francisco, 

Cal.) Capt., A.U.S. 

Harris, D M.. Sioux City (APO 444, New York, 

N. Y.) Capt., A.U.S. 

Heffernan, C. E., Sioux City (APO 17682, San 

Francisco, Cal.) Capt., A.U.S. 

Hicks, W. K., Sioux City (Spokane, Wash.) Major, A.U.S. 

Honke, E. M., Sioux City (Palm Springs, Cal.) Major, A.U.S. 

Kaplan, David, Sioux City (APO 36, New York, 

N. Y.) Capt., A.U.S. 

Knott, P. D., Sioux City (Camp Crowder, Mo.) Capt., A.U.S. 

Knott, R. C., Sioux City (APO 403, New York, 

N. Y.) Major, A.U.S. 

Krigsten, W. M., Sioux City (Springfield, Mo.)...Lt. Col., A.U.S. 

Lande, J. N., Sioux City (APO 63, New York, N. Y.) Major, A.U.S. 

Martin, R. F., Sioux City (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Mattice, L. H., Danbury (APO 713, San Francisco, 

Cal.) 1st Lt., A.U.S. 

McCuistion, H. M., Sioux City (APO 209, New York, 

N. Y.) Capt., A.U.S. 

Mugan, R. C.. Sioux City (Miami Beach, Fla.) Capt., A.U.S. 

Osincup, P. W., Sioux City (APO 520, New York, 

N. Y.) Capt., A.U.S. 

Rarick, I. H., Sioux City (Camp Pinedale, Cal.) .... Capt., A.U.S. 

Reeder, J. E.. Jr., Sioux City (APO 209, New York, 

N. Y.) Capt., A.U.S. 

Ryan, M. J., Sioux City (Topeka, Kan.) Major, A.U.S. 


Schwartz, J. W., Siou.x City (APO 883, New York, 


N. Y.) Lt. Col., A.U.S. 

Tracy, J. S.. Sioux City (APO 569, New York, 

N. Y.) Major, A.U.S. 

Worth County 

Westly, G. S.. Manly (APO 927, San Francisco, 

Cal.) Major, A.U.S. 


Wrisht County 

Aagesen, C. A., Dows (APO 383, New York, N. Y.) 

Capt., A.U.S. 

Bird, R. G., Clarion (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Doles, E. A., Clarion (Spokane, Wash.) Capt., A.U.S. 

Gorrell, R. L., Clarion (Denver, Colo.) ... .P.A. Surg., U.S.P.H.S. 
Leinbach, S. P., Belmond (Farragut Air Base, Idaho) 

Missildine, W. H., Eagle Grove (APO 25, San Francisco, 

Cal.) Capt., A.U.S. 


(•) Reported missing in action. 
(1) Reported deceased in service, 
(.t) Reported prisoner of war. 


CONGENITAL MALFORMATIONS ARISING 
FROM DEFICIENT MATERNAL DIET 

(Continued from page 51) 

of gestation. It is at this state in fetal develop- 
ment that undifferentiated mesenchymal structures 
develo]) into the well-differentiated membranous 
skeletal elements which are the forerunners of the 
cartilaginous and osseous skeleton. Apparentlv 
the membranous skeleton exists only for a short 
period and it is then that it is vulnerable to the 
presence or absence of riboflavin. 

Still another type of congenital malformation 
could he regularly induced in about 45 per cent 
of the young if liver were added to the Steenhock 
and Block rachitogenic deficient diet hut vitamin 
D withheld. The pattern of skeletal deformities 
resulting from this ty])e of deficient diet was curv- 
ing of the ulna, radius, tibia, fibula, and angulation 
and broadening of the rilis in their osseous parts. 
Again addition of vitamin 1) to the maternal diet 
lirevented these malformations. 

Perhaps the most important lesson to he learned 
from Warkany’s study on animals is that the con- 
ception once generally held that congenital mal- 
formations w'ere the result of defective genes and 
therefore nothing could be done may not be al- 
together true. Certainly the correlation of W'ar- 
kany's observations as it relates to the human pre- 
sents a most promising line of investigation and 
one which will he watched with great interest. In 
the meantime an additional responsibility would 
seem to have been imposed upon the obstetrician 
to make certain that the diet of his pregnant pa- 
tients is complete in all respects. 


The Annual Clinical Conference of the 
Chicago Medical Society, scheduled for 
February 27, 28 and March 1, has been 
cancelled as a contribution to the war 
effort. 


66 


Journal of Iowa State Medical Society 


February, 1945 


COUNTY 

COUNTY MEDICAL SOCIETY OFFICERS 

PRESIDENT SECRETARY DEPUTY COUNCILOR 

Adair 

. .R. E. Wiley, Fontanelle 

.A. S. Bowers, Orient..., 

.A. S. Bowers, Orient 

Adams 

..A, W. Brunk, Prescott 

J. H. Wallahan, Corning 


Allamakee 

.J. W. Myers, Postville 

. J. W. Thornton, Lansing 

.J. W. Thornton, Lansing 

Appanoose 

.J. C. Donahue, Centerville 

. R. L. Fenton, Centerville.. 

.C. S. Hickman, Centerville 

Audubon 

. .L. E. Jensen, Audubon 

. W. H. Halloran, Audubon 

.L. E. Jensen, Audubon 

Benton 

.N. B. Williams. Belle Plaine 

. D. A. Dutton, Van Horne 

.N. B. Williams, Belle Plaine 

Black Hawk 

.H. A. Bender, Waterloo 

,S. A. Barrett, Waterloo 

.A. J. Joynt, Waterloo 

Boone 

. A. B. Deering, Boone 

. B. T. Whitaker. Boone 

.J. 0. Ganoe, Ogden 

Bremer 

. 0. C. Hardwig, Waverly 

,M. N. Gernsey, Waverly 

.F. R. Sparks, Waverly 

Buchanan 

. ,N. L. Hersey, Independence 

, J. W. Barrett, Jr„ Independence. 

.C. W. Tidball, Independence 

Buena Vista 

. J. H. O’Donoghue, Storm Lake. . . 

.T. R. Campbell, Sioux Rapids.... 

.H. E. Farnsworth, Storm Lake 

Butler 

. .J. G. Evans, New Hartford 

,F. F. McKean, Allison 

.Bruce Ensley, Shell Rock 

Calhoun 

. P. W. Van Metre, Rockwell City. . 

• D. C. Carver, Rockwell City 

.R. G. Hinrichs, Manson 

Carroll 

. A. R. Anneberg, Carroll 

. P, D. Anneberg. Carroll 

. W. L. McConkie, Carroll 

Cass 

. ,G. A. Alliband, Atlantic 

. R. L. Barnett, Atlantic 

. W. S. Greenleaf, Atlantic 

Cedar 

. Fred Montz, Lowden 

.J. E. Smith, Clarence 

.P. M. Hoffman, Tipton 

Cerro Gordo 

. S. A. O’Brien, Mason City 

. R. E. Smiley, Mason City 

.G. J. Sartor, Mason City 

Cherokee 

,C. W. Ihle, Cleghorn 

,D. C. Koser, Cherokee 

.C. H. Johnson, Cherokee 

Chickasaw 

.Nicholas Schilling, New Hampton 

. J. E. Murtaugh, New Hampton.. 

.P. E. Gardner, New Hampton 

Clarke 

. ,F. S. Bowen, Woodburn 

. C. R. Harken, Osceola 

.H. E. Stroy, Osceola 

Clay 

. ,T. H. Johnston, Spencer 

,C. C. Collester, Spencer 

.J. M. Sokol, Spencer 

Clayton 

. J. C. Brown, Littleport 

.P. R. V. Hommel, Elkader 

.P. R. V. Hommel, Elkader 

Clinton 

. R. E. Dwyer, Clinton 

J. E. O’Donnell, Clinton 

.R. F. Luse, Clinton 

Crawford 

. E. V. ZaesUe, Charter Oak 

.Dora E. K. Zaeske, Charter Oak. 

. C. L. Sievers, Denison 

Dallas-Guthrie 

. C. E. Porter, Redfield 

. S. J. Brown, Panora 

.E, J. Butterfield, Dallas Center 

Davis 

. ,C. H. Cronk, Bloomfield 

,H. C. Young, Bloomfield 

S. J. Brown, Panora 
.H. C. Young, Bloomfield 

Decatur 

. .H. M. Hills, Lamoni 

.K. R. Brown, Lamoni 

F. A. Bowman, Leon 

Delaware 

. C. B. Rogers, Earlville 

Paul Stephen, Manchester 

..J. K. Stepp, Manchester 

Des Moines 

. D. F. Huston, Burlington 

W. R. Lee, Burlington 

.F. G. Ober, Burlington 

Dickinson 

. ,T. L. Ward, Arnolds Park 

Ruth F. Wolcott, Spirit Lake.... 

.T. L. Ward, Arnolds Park 

Dubuque 

. .H. E. Thompson, Dubuque 

J. W. Lawrence. Dubuque 

.J. C. Painter, Dubuque 

Emmet 

..S. C. Kirkegaard, Estherville. . . 

L. W. Loving, Estherville 

. S. C. Kirkegaard, Estherville 

Fayette 

.C. C. Hall, Maynard 

.A. F. Grandinetti. Oelwein 

• C. C. Hall, Maynard 

Floyd 

. C. H. Cords, Rudd 

. R. A. Fox, Charles City 

. R. A. Fox, Charles City 

Franklin 

. . J. C. Powers, Hampton 

. F. L. Siberts, Hampton 

.J. C. Powers, Hampton 

Fremont 

• Ralph Lovelady, Sidney 

A. E. Wanamaker, Hamburg.... 

.A. E. Wanamaker, Hamburg 

Greene 

. .L. C. Nelson, Jefferson 

,J. R. Black, Jefferson 


Grundy 

. C. H. Bartruff, Reinbeck 

. G. A. Biebesheimer, Reinbeck.... 

.W. 0. McDowell, Grundy Center 

Hamilton 


M. B. Galloway, Webster City... 

• M. B. Galloway, Webster City 

Hancock-W innebago 

• C. V. Hamilton. Garner 

W. F. Missman. Klemme 

,C. V. Hamilton, Gamer 

Hardin 

. G. A. Blaha, Whitten 

,W. E. Marsh, Eldora. ’. 

G. F. Dolmage, Buffalo Center 
.F. N. Cole, Iowa Falls 

Harrison 

Henry 

.R. H. Cutler, Little Sioux 

. S. W. Huston, Mt. Pleasant 

,F. H. Hanson, Magnolia 

J. S. Jackson, Mt. Pleasant 

.S. W. Huston, Mt. Pleasant 

Howard 

. ,W. A. Bockoven, Cresco 

,F. E. Giles. Cresco 

.W. A. Bockoven, Cresco 

Humboldt 

.C. A. Newman, Bode 

. R, W. Beardsley, Livermore 

. I. T. Schultz, Humboldt 

Ida 

. H. H. Harris, Battle Creek 

W. P. Crane, Holstein 

.E. S. Parker, Ida Grove 

Iowa 

. E. L. Hollis, Marengo 



Jackson 

.B. B. Dwyer, Preston 

,F. J. Swift, Maquoketa 

. F. J. Swift, Maquoketa 

Jasper 

.R. F. Freeh, Newton 

,T. D. Wright, Newton 

• R. W. Wood, Newton 

Jefferson 

.L. D. James, Fairfield 

I. N. Crow, Fairfield 

■ I. N. Crow, Fairfield 

Johnson 

.M. L. Floyd, Iowa City 

R. H. Flocks, Iowa City 

■ G. C. Albright, Iowa City 

Jones 

.J. D. Paul, Anamosa 

C. R. Smith, Onslow 

.'T. M. Redmond, Monticello 

Keokuk 

,T. J. G. Dulin, Sigourney 

John Maxwell, What Cheer 

. C. L. Heald, Sigourney 

Kossuth 

. P. V. Janse, Algona 

,M. G. Bourne, Algona 

J. G. Clapsaddle, Burt 

Lee 

. .W. M. Hogle, Keokuk 

H. F. Noble, Fort Madison 

. R. L. Feightner, Ft. Madison 

Linn 

. B. J. Moon, Cedar Rapids 

,D. S. Challed, Cedar Rapids 

B. L. Gilfillan, Keokuk 
.B. F. Wolverton, Cedar Rapids 

Louisa 

J. W. Pence. Columbus Junction. 

L. E. Weber, Wapello 

.J. H. Chittum, Wapello 

Lucas 

. H. D. Jarvis, Chariton 

R. E. Anderson, Chariton •• 

■ S. L. Throckmorton, Chariton 

Lyon 

H. E. Carver, Earlham 

J. H. Sherlock, Rock Rapids 

.G. M. DeYoung, George 

Madison 

E. M. Olson, Winterset 

• C. B. Hickenlooper, Winterset 

Mahaska 

L. F. Catterson, Oskaloosa 

.F. A. Gillett, Oskaloosa 

.L. F. Catterson, Oskaloosa 

Marion 

F. M. Roberts, Knoxville 

. E. C. McClure, Bussey 

E. C. McClure, Bussey 

Marshall 

B. S. Wells, Marshalltown 

G. M. Johnson. Marshalltown... 

.A. D. Woods, State Center 

Mills 

T. B. Lacey, Glenwood 

I. U. Parsons, Malvern 

.D. W. Harman, Glenwood 

Mitchell 

G. E. Krepelka, Osage 

J. 0. Eiel, Osage 

.T. S. Walker, Riceville 

Monona 

E. J. Liska, Ute 

E. E. Gingles, Onawa 

.C. W. Young, Onawa 


J. F. Stafford, Lovilia 

T. A. Moran, Melrose 

. T. A. Moran, Melrose 

Montgomery 

Gladys Cooper, Red Oak 

Velura E. Powell, Red Oak 


Muscatine 

L. C. Howe, Muscatine 

J. L. Klein, Jr., Muscatine 

. T. F. Beveridge, Muscatine 


C. A. Samuelson, Sheldon 

■ W. S. Balkema, Sheldon 

.W. R. Brock, Sheldon 

Osceola 

E. P. Farnum, Sibley 

H. B. Paulsen, Harris 

.Frank Reinsch, Ashton 

Page 

N. M. Johnson, Clarinda. 

J. F. Aldrich, Shenandoah 

. W. H. Maloy, Shenandoah 

Palo Alto 

.J. P. McManus, Graettinger 

P. 0. Nelson, Emmetsburg 

.H. L. Brereton, Emmetsburg 

Plymouth 

M. J. Joynt, Le Mars 

L. C. O’Toole, Le Mars 

.W. L. Downing, Le Mars 

Pocahontas 

. W. E. Gower, Pocahontas 

G. A. Everson, Rolfe 

.J. H. Hovenden, Laurens 

Polk 

A. E. Merkel, Des Moines 

E. W. Anderson, Des Moines 

.J. B. Synhorst, Des Moines 

Pottawattamie 

. F. E. Marsh, Council Bluffs 

,G. V. Caughlan, Council Bluffs... 

.G. N. Best, Council Bluffs 

Poweshiek 

. H. C. Parsons, Grinnell 

C. E. Harris, Grinnell 

.C. E. Harris, Grinnell 

Ringgold 

. .0. L. Fullerton, Redding 

J. W. Hill, Mt. Ayr 

.E. J. Watson, Diagonal 

Sac 

. A. A. Blum, Wall Lake 

J. W. Gauger, Early 

.J. R. Dewey, Schaller 

Scott 

. A. A. Garside, Davenport 

L. J. Miltner, Davenport 

.A. P. Donohoe, Davenport 

Shelby 

.J. P. McGowan, Harlan 



Sioux 

.A. L. Lock, Rock Valley 

. Wm. Doornink, Orange City 

.Wm. Doornink, Orange City 

Story 

..Julia Cole, Ames 

W. B. Armstrong, Ames 

.Bush Houston, Nevada 

Tama 

.G. T. McDowall, Gladbrook 

G. M. Dalbey, Traer 

.A. A. Pace, Toledo 

Taylor 

,C. E. Buckley, Blockton 

J. H. Gasson, Bedford 

,G. W. Rimel, Bedford 

Union 

. J. A. Liken, Creston 

C. E. Sampson, Creston 


Van Buren 

. Roscoe Pollock. Douds-Leando. . . 

.J. A. Craig, Keosauqua 

.L. A. Coffin, Farmington 


, S. F. Singer, Ottumwa 

L. A. Taylor, Ottumwa 

.E. B. Hoeven, Ottumwa 


,G. A. Jardine, New Virginia.... 

C. H. Mitchell, Indianola 

.C. H. Mitchell, Indianola 

Washington 

.W. L. Alcorn, Washington 

W. S. Kyle, Washington 

. E. D. Miller, Wellman 

Wayne 

. D. R. Ingraham. Sewal 

C. F. Brubaker, Corydon 

.L. B. Calbreath, Humeston 


. E. F. Beeh, Fort Dodge 

.P. C. Otto, Fort Dodge 

.H. E. Nelson. Dayton 

Winneshiek 

. V. J. Horton, Calmar 

R. M. Dahlquist. Decorah 

. L. C. Kuhn, Decorah 

Woodbury 

. C. A. Katherman, Sioux City 

R. T. Rohwer, Sioux City 

. D. B. Blume, Sioux City 

Worth 

.B. H. Osten, Northwood 

M. P. Allison. Northwood 

. S. S. Westly, Manly 

Wright 

. B. L. Basinger, Goldfield 

J. R. Christensen, Eagle Grove. . . 

. J. H. Sams, Clarion 2-1-45 


Journal of Iowa State Medical Society 


67 


WOMAN’S AUXILIARY NEW: 


Mrs. Keith M. Chaplee, Chairman of Press and Publicity Committee, Dexter, Iowa 


President — Mrs. Jay C. Decker, Sioux City 
President-Elect — Mrs. Soren S. Westly, Manly 
Secretary — Mrs. Allen C. Starry, Sioux City 
Treasurer — Mrs. Arthur E. Merkel, Des Moines 


REPORT OF FALL CONFERENCE 

The first fall conference of presidents and presi- 
dents-elect was held in Chicago' at the Palmer House, 
November 16 and 17. 

On Thursday, November 16, at 9:30 a.m., the con- 
ference was called to order. The National President 
of the Woman’s Auxiliary to the American Medical 
Association, Mrs. David W. Thomas, expressed her 
appreciation that so many were in attendance during 
this time of- inconvenience of travel. Mrs. Thomas 
referred to the heroic efforts of the Medical profes- 
sion in this war. We as Auxiliaries are deteiTnined 
to serve and do all we can to help the American 
Medical Association. 

Mrs. Roscoe E. Mosiman of Seattle, Washington, 
was elected as conference chairman and Mrs. R. M. 
Shaffer of Kansas as recording secretary. Reports 
of the president and committee chairmen were given. 
Greetings were extended by Dr. Frank Hammond of 
the Chicago Medical Society. 

At the noon luncheon held at the Palmer House, 
guest speakers were Dr. Herman L. Kretschmer, 
President, American Medical Association; Dr. Roger 
I. Lee, President-Elect; Dr. Morris Fishbein, Editor 
of the Jaiimal of the American Medical Association 
and Hygeia, and Dr. W. W. Bauer, Director of Health 
Education. Di*. Kretschmer stressed leadership 
among members of the Auxiliaries in the furtherance 
of public health. Dr. Lee told of the postwar medical 
service which will help the medical officers returning 
from war zones. Dr. Fishbein, substituting for Colo- 
nel Leonard G. Rowntree, Chief of the Medical Divi- 
sion of Selective Service System, stressed “Physical 
Fitness.” Numerous large industrial organizations 
are inaugurating programs for physical fitness 
among their workers. He also urged members to add 
Hygeia to their magazine list. 

Dr. W. W. Bauer told of the fine work radio is 
doing in Health Education. There are many excel- 
lent transcribed programs which can be used over 
our radio stations, arranged for five to fifteen min- 
utes of time. There are also many groups of records 
which can be used in schools or for clubs or county 
auxiliaries. One series is entitled “Medicine Serves 
America,” another, “More Life for You,” and there 
is also one recording on “Cancer.” All or any of 
these can be obtained by writing Dr. W. W. Bauer, 
635 North Dearborn Street, Chicago 1.0, Illinois. 


Don’t forget “Doctors at War” every Saturday after- 
noon from 3:00 until 3:30 o’clock. 

Roll call Friday morning showed many state presi- 
dents and presidents-elect in attendance. Iowa was 
represented by your president and Mrs. S. S. Westly, 
president-elect. In the past year Illinois initiated 
a school of instruction for officers and reported they 
believed it would prove worth while. All states re- 
ported members were participating in war activities 
such as Red Cross, war loan drives, blood banks and 
canteen work. All reported hoping to hold their 
memberships as of the past year and some told of 
showing an increase. Many states reported the 
Bulletin a real inspiration to its members, and urged 
every member to be a subscriber. Send your Bulletin 
subscriptions to our chairman, Mrs. Matthew J. 
Moes, Dubuque, Iowa. 

Mrs. David W. Thomas, National President, of 
Lock Haven, Pennsylvania, has accepted the invita- 
tion of the Woman’s Auxiliary to the Iowa State 
Medical Society to be the guest speaker at its annual 
meeting, April 19, in Des Moines. 

Best wishes to every member and may this new 
year of 1945 bring a victorious peace. 

Mrs. Jay C. Decker, President 


Activities of the Sioux Med- Dames 
The Sioux Med-Dames of Sioux City gave a tea 
honoring their State President, Mrs. J. C. Decker, 
and their State Secretary, Mrs. A. C. Starry. It was 
held in the home of Mrs. W. H. Gibbon on September 
10, 1944. Mrs. R. E. Crowder, president of the Sioux 
Med-Dames, presided at the meeting. Mrs. Decker 
brought inspirational suggestions and reported on 
the increased number of subscriptions to Hygeia. 

The Christmas luncheon was held December 13 at 
the Warrior Hotel. It was made most enjoyable by 
a musical program. One of the members, Mrs. W. K. 
Hicks, sang, and the Gray Ladies Glee Club pre- 
sented several selections. Mrs. P. L. Bettler, a mem- 
ber who sang in the group, is a nurses aide. As is 
the custom, a Good Fellows offering was taken and 
all responded generously. Work in the Lehan Nurs- 
ery Project was reported to be progressing well. 

The ladies were invited to the dinner meeting of 
the Woodbury County Medical Society which was 
held December 14. It was in honor of Dr. Prince 


68 


jouKNAt, OF Iowa State Medical Society 


Sawyer who had completed fifty years in the practice 
of medicine. The meeting- was well attended, there 
being many doctors and their wives from sur- 
x'ounding towns both in and out of Woodbury County. 
The speaker of the evening was Dr. Claude Dixon 
of the Mayo Clinic in Rochester, Minnesota. 

Mrs. E. H. Sibley, Secretary 


Meeting of the Polk County Auxiliary 

The Auxiliary to the Polk County Medical Society 
met in Des Moines at Younkers Tea Room, November 
17, with forty-eight in attendance. 

Committee reports were given. The Hygeia Com- 
mittee reported that it had placed the magazine in 
the Roadside Settlement, Southside Community 
House, Salvation Army, Jewish Community Center, 
the Y.M.C.A. and the Y.W.C.A. The subscription 
of the Locust Street U.S.O. was voted Renewed. One 
of the committee members personally subscribed for 
the elementary school and the library of West Des 
Moines. 

A resolution was adopted that the Polk County 
Auxiliary offer its encouragement and assistance to 
the extension of the Red Cross Home Nursing train- 
ing throughout the community. 

An announcement was made of the one day public 
health conference to be held December 6 at the 
Y.W.C.A. “War Health Findings in Polk County 
and Their Meaning for the Future” was the subject 
of the conference. The president stated that the 
Auxiliary had been requested to furnish three regis- 
trars for the meeting. 

The -wives of nine of our doctors in service were 
introduced by the president, Mrs. McPherrin. Each 
wife told where her husband was stationed. 

The president presented the speaker of the after- 
noon, Dr. Martin I. Olsen, who spoke on the “Pro- 
posed Plan for Medical Care in Iowa.” 

Mrs. M. A. Royal, Secretary 


PHYSICAL FITNESS OBJECTIVES* 

1. Help each American learn physical fitness 
needs. 

2. Protect against preventable defects. 

3. Attend to correctable defects. 

4. Know how tO' live healthfully. 

5. Act to acquire physical fitness. 

6. Set American standards of physical fitness at 
high levels. 

7. Provide adequate means for physical develop- 
ment. 

*From editorial by Morris Fishbein, M.D., in the September 
1&44 issue of Hygeia. 


The Woman’s Auxiliary to the American 
Medical Association has cancelled its annual 
meeting, scheduled to have been held in Phila- 
delphia June 18 to 22, as a contribution to the 
war effort. 


Speakers Bnreaiu Activities 


NEUROPSYCHIATRIC FILMS AVAILABLE 

The Speakers Bureau is pleased to announce that 
a series of motion picture films on neuropsychiatric 
disorders has been made available to medical and 
strictly scientific group's for educational purposes by 
a new department of medical films in the New York 
University Film Library. 

The series of eleven films is the work of S.- Philip 
Goodhart, M.D., Chief of the Neuropsychiatric Divi- 
sion of Montfiore Hospital, New York, and Professor 
of Clinical Neurology at Columbia University; and 
Major Benjamin H. Balser, M.C., Consultant in 
Neuropsychiatry, First Air Force, and Associate in 
Neurology at Columbia University. 

The films have been used for a number of years in 
courses given to medical students at Columbia Uni- 
versity and are now being made available for teach- 
ing purposes and professional discussion groups 
thi'ough the medical department of the New York 
University Film Library. 

Following is the list of 16 mm. films included in 
this series: Chorea, ten minutes; Convulsive and Al- 
lied Conditions, eleven minutes; Dystonia Muscu- 
lorum Deformans, twenty minutes; Encephalograph- 
ic Studies in Extrapyramidal Diseases, nine min- 
utes; Epidemic Encephalitis, eighteen minutes; 
Friedreich’s Hereditary Ataxia and Little’s Disease, 
ten minutes; Neuro-Ophthalmological Conditions — 
Pathological Ocular Manifestations of Clinical Inter- 
est, eleven minutes; Progressive Hep'ato-Lenticular 
Degeneration, nine minutes; Progressive Muscular 
Atrophies, Dystrophies and Allied Conditions, fifteen 
minutes; Psychoneuroses, sixteen minutes; and Som- 
atic Endocrine Types, fifteen minutes. 

Arrangements for the use of these prints may be 
made through the Speakers Bureau. The request 
should be made at least three weeks in advance of 
the meeting date, and it is usually ad-visable to state 
a first and second choice. 


SPEAKERS BUREAU RADIO SCHEDULE 


WOI — Tuesdays at 1:00 p. m. 

WSUI — Thursdays at 9.00 a. m. 

February 6- 8 Venereal Disease 

Harry A. Stribley, M.D. 

February 13-15 The Treatment of Pneumonia 

Ralph E. Munden, M.D. 

February 20-22 Measles 

Nelle E. T. Schultz, M.D. 


February 27- 
March 1 


Common Causes of Headache 

William Doornink, M.D. 


[OURNAL OF ToVVA StATE. MeFIICAL SOCIETY 


69 


History of Medicine in Iowa 

Edited by the Historical Committee 

Dr. Walter L. Bierring, Des Moines, Chairman 
Dr. Henry G. Langworthy, Dubuque, Secretary Dr. John T. McClintock, Iowa City 

Dr. Murdoch Bannister, Ottumwa Dr. Frank E. Sampson, Creston 


WILLIAM W, BOWEN, 
1869—1944 
An Appreciation 


In the spring’ of 1901 the writer was passing 
through Berlin and visited the pathologic department 
of the Charite Hospital to see once more the great 
master, Professor Rudolph Virchow, then in his 
eightieth year. In passing through the laboratory 
adjacent to the autopsy room, one of the workers 
arose from a laboratory stool and extended a hand 
of greeting — it was Dr. Bowen of Fort Dodge. After 
a few words over the surprise and pleasure of the 
meeting, we passed into the autopsy room where Pro- 
fessor Virchow was demonstrat- 
ing the organs from a patient who 
had died of leukemia. It was evi- 
dent that Dr. Bowen had made a 
good impression on his great 
teacher and associates as regards 
his earnest desire to study clin- 
ical pathology under their tute- 
lage. The constant urge to learn 
of the newer developments in 
medical science dominated the en- 
tire professional career of our 
Iowa colleague. In the succeed- 
ing forty-five years of active med- 
ical service scarcely a year passed 
by that he did not make a study 
visit to one of the larger medical 
centers in this country. He was 
regarded as one of the Iowa pio- 
neers in the field of radiology, 
particularly in x-ray diagnosis 
and the therapeutic use of x-ray 
and radium. This was carried on 
in connection with an active surgical practice. 

On April 16, 1940, more than a hundred of his 
medical friends gave him a testimonial dinner to 
commemorate the completion of forty-five years of 
medical practice in Iowa. The many tributes of re- 
gard expressed on this happy occasion indicated the 
high place he had attained in Iowa medicine and in 
the affection of his colleagues. 

Dr. Bowen was a member of a quartette often re- 
ferred to as the four musketeers, comprising Dr. L. 
C. Kern of Waverly, the late Dr. J. A. W. Burgess 
of Iowa Falls, and Dr. Albert M. Barrett of Ann 
Arbor, Michigan. The latter for many years was 


professor of neurology and psychiatry and director 
of the State Psychiatric Hospital at the University 
of Michigan. This quartette of medicos roomed to- 
gether, had their own quiz class, and every five years 
after graduation had a reunion and a group photo- 
graph taken. 

Many honors came to Dr. Bowen during his long 
and distinguished career. He was a charter member 
of the American Radiological Society, a Fellow 
(founders group) of the American Colleg’e of Sur- 
geons, a past president of the 
Iowa State Medical Society 
(1933), the Webster County Med- 
ical Society, Iowa X-ray Club, and 
the Austin-Flint and Twin Lakes 
Medical Societies. In his later 
years he became an ardent stu- 
dent of medical history, and con- 
tributed a very complete and in- 
teresting chapter to Iowa medical 
history in his story of medicine in 
Webster County published in the 
Journal in 1942. 

He was a member of the Fort 
Dodge Art Guild and his talent 
of pen and ink drawing is shown 
in his fine collection of colored 
drawings of birds displayed at the 
Blandon Memorial Art Gallery. 

His death caine after a brief 
illness, December 20, 1944, at the 
age of seventy-five years. He is 
survived by his wife, the former 
Lydia May King, and two children, Harold K. of 
Osceola, and Mrs. Rex Ingram of Iowa City,* and 
three grandchildren. 

Dr. Bowen was born in 1869 in Egypt, Illinois, and 
received his degree of Doctor of Medicine at the Uni- 
versity of Iowa in 1895. He practiced medicine five 
years in Whittemore, Iowa, before locating in Fort 
Dodge in 1901. In his death Iowa Medicine mourns 
a great leader, a medical scholar, a genial and be- 
loved colleague who exemplified the best ideals of 
cur profession. — Walter L. Bierring, M.D. 

*Dr. Rex Ingram, Professor of Anatomy. University of Iowa 



WILLIAM W. BOWEN. M.D. 


70 


Journal of Iowa State Medical Society 


February, 1945 


Medical History of Wapello County 

Clyde A. Henry, M.D., Parson 
Part III 

(Continued from last month) 


CIVIL WAR PHYSICIANS 

Physicians who served in the Civil War, enlisting 
as residents of the county or locating here at the 
close of the war, were Drs. S. B. Thrall, W. L. 
(drr, J. W. LaForce, D. A. LaForce, B. W. Searle, 
J. C. Hinsey, Dudley W. Stewart, D. C. Dinsmore, 
G. M. Cowger, E. L. Lathrop, Charles G. Lewis 
and Seymour Carpenter. ^ 

After the Civil War, the Wapello County Medi- 
cal Society was reorganized. Writing of the year 
1876, Dr. Fairchild, in his “Medicine in Iowa,” 
has this to say of that event : “A well organized 
Medical Society has been maintained with regular 
monthly meetings for seven years past, embracing 
nearly all the regular physicians in the County.” 
According to this statement, the reorganization of 
the Society occurred in 1869. 

But Dr. A. O. Williams, who became a member 
of the Society April 6, 1875, while a resident of 
Eldon, years afterwards wrote as follows : 

“During the Civil War the Society did not meet, 
and not until 1870 was the Wapello County Medi- 
cal Society again reorganized with Dr. W. L. Orr, 
President ; Dr. T. J. Douglass, Vice President : and 
Dr. J. Williamson, Secretary. Since this reorgani- 
zation in 1870 the Wapello County Medical So- 
ciety has met uninterruptedly.” 

A LOST RECORD BOOK 

At a regular meeting of the Society on October 
15, 1907, Dr. J. F. Herrick, who was then secre- 
tary, w'as ordered to deposit Record Book No. 2 
in the Ottumwa Library for safe keeping. That 
the order was duly executed is attested by Dr. 
Herrick’s own hand in Record Book No. 3. This 
hook, so vitally important in the preparation of a 
connected history of the Society, cannot he found. 
Someone must have removed the book unbeknown 
to the Librarian. Whether negligence or willful 
intent accounts for its disappearance, the Wapello 
County Medical Society suffers a great loss. Who 
got the book, and why is the Library record in- 
complete ? 

The Lost Book period, beginning in 1869 or 
1870 and continuing through the years to October 
1, 1907, will be bridged by excerpts of articles and 
items which appeared in the loiva State Medical 
Reporter and the Iowa State Medical Journal, 
and other available sources. 


Early in this period instruments of precision 
liegan to make their appearance. One of these 
was the self-registering thermometer. Zealous of 
the skill acquired and enjoyed by competent physi- 
cians in clinical diagnoses. Dr. S. B. Thrall was 
prompted to prepare and read a paper entitled, 
"Remarks on the Clinical Thermometer,” before 
the Wapello County Medical Society on December 
4, 1883. The following excerpt is taken from the 
paper, which was published in the December issue 
of the lou’a State Medical Reporter, Vol. 1, num- 
ber 6: 

“Its tendency is to lessen in the minds of the 
people their faith in the mental powers of re- 
search of the physician who relies upon the indi- 
cations of a self-registering instrument for his 
opinion of vital phenomena.” 

Dr. J. Williamson read a paper, “Injuries of 
the Perineum,” at the Thirty-first Annual Meeting 
of the Iowa State Medical Society, in Council 
Bluffs, May 16 and 17, 1883. At the same meet- 
ing, Drs. J. C. Plinsey and S. B. Thrall were two 
of the thirty-seven delegates nominated as dele- 
gates to the American Medical Association to meet 
June 5 in Cleveland. Both attended and both' 
served on various committees. 

“The poixilation of Wapello County in 1876 
was 22,261. The number of educated practicing 
physicians was 25 ; two were listed as homeopaths^ 
one an eclectic, and the remainder regular. There 
ivas one female practitioner, a graduate of Wom- 
an’s Medical College at Philadelphia. 

“Surgical operations of which mention might be 
made are: Ovariotoni)^ in 1872 by J. Williamson; 
recovery. Vesico- Vaginal fistula in 1874 by J. 
Williamson ; successful. A case of united twins, 
reported to the Iowa State Medical Society by 
J. Williamson in 1871. Ovariotomy in 1873 by 
J. C. Hinsey : death.” 

— lotm State Medical Reporter. 

growing needs in ethical practice 

Dr. J. Williamson delivered the Annual Address 
to the graduating class of the Iowa College of 
Physicians and Surgeons in March, 1884. Al- 
though the Medical Practice Act w'as passed two 
years later, the problem referred to in the follow- 
ing excerpt from that able address is as far from 
being solved as it was sixty years ago : 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


71 


“Professional consultation is a subject that 
will sooner or later cause you some annoyance, for 
it seems impossible for the laity to understand why 
a regular physician cannot consult with a homeo- 
pathist, or with anyone who may choose to call 
himself a doctor. There is no law in Iowa regu- 
lating the practice of medicine, and the conse- 
quence is that a most motley set have come to- 
gether within our borders. Looking out upon 
the fields, so varied are the shades, one is re- 
minded of Jacob’s flocks, all speckled and spotted 
and streaked, while many of the self-styled doc- 
tors are about as wise in medicine as Rev. Jasper 
is in astronomy. Here are the herb doctor, the 
Indian doctor, the cancer doctor, the rubbing doc- 


tor, the magnetic doctor, and many others, some 
of whom boast that they never learned to read. 
These pretenders have an equal right with your- 
selves to practice medicine in Iowa. Why this is 
so, is a question we would be glad to have our 
])resent legislators answer.” 

The great middle-west has won notoriety in 
more fields than agriculture. For instance, there 
were the goat glands of Milford; the Cancer In- 
stitute of Muscatine : and, at a very early date, the 
Paul Castor Infirmary at Ottumwa. Perhaps the 
psychometrist is yet unborn who can explain in 
understandable language why such things hap- 
]ien. But this is what Dr. Williamson wrote about 
the latter institution many years ago : 


“In the allotment of Providence it was reserved 
for Ottumwa, the County seat of Wapello County, 
to lie the location of what is known throughout 
the country as Paul Castor’s Infirmary. It was 
started in 1858 by one Paul Castor and has re- 
mained under his management ever since with 
such hired assistants as have been found neces- 
sary. (He is fifty years old, corpulent, coarse 
and uncouth in his physique, without education 
or knowledge of the world gained by travel, and 
with a defective articulation, rendering it difficult 
for a stranger to understand his speech, but with 
a fair share of natural sense and shrewdness.) 
This man publicly gave out that to him was com- 
municated the divine apostolic gift of healing the 


sick by the laying on of hands and rubbing of the 
affected parts. To this claim of supernatural 
]>ower has lately been added a claim to the so- 
called magnetic forces. Thus equipped, this in- 
firmary which was started eight years ago with- 
out money or influential friends, has become the 
resort of invalids from all parts of our common 
country. The capacity of the infirmary is 100 
rooms with accommodations for at least 150 pa- 
tients. The net profit of rubbing for the year 
1865 is reported to be $16,000. The receipts aris- 
ing from the hotel department are not included 
in these figures.” — J. Williamson. 

How they worked, and what they labored for 





LATER PROMINENT PHYSICIANS 

Top Row: Alice M. Stark, C. B. Lewis, C. G. Lewis. E. T. Edgerly 
Center Row: D. A. LaForce, T. J. Douglass, A. O. Williams, B. W. Searle, L. P. Torrence 
Bottom Row: H, H. Webb, W. B. LaForce. M. F. Moore. Evon Walker, Wm. Hansell 


(Continued on page 76) 


72 


Journal oI' Towa .Statk Medical Society 


THE JOURNAL BOOK SHELF 


BOOKS RECEIVED 


LIPPINCOTT’S QUICK REFERENCE BOOK FOR MEDICINE 
AND SURGERY, a Clinical, Diagnostic, and Therapeutic Di- 
gest of General Medicine, Surgery, and the Specialties, 
Compiled Systematically from Modern Literature — By George 
E. Rehberger, M.D. Twelfth edition. J. B. Lippincott Com- 
pany, Philadelphia, 1944. Price, $16.00. 

ARTHRITIS AND ALLIED CONDITIONS— By Bernard I. Corn- 
roe, M.D., Associate in Medicine, University of Pennsylvania, 
Senior Ward Physician and Chief of the Arthritis Clinic, 
Hospital of the University of Pennsylvania. Third edition, 
enlarged and thoroughly revised. Lea & Febiger, Phila- 
delphia, 1944. Price, $12.00. 

ATLAS OF THE BLOOD IN CHILDREN— By Kenneth D. Black- 
fan. M.D., Late Thomas Morgan Rotch Professor of Pedia- 
trics, Harvard Medical School. Late Physician-in-Chief, In- 
fants’ and Children’s Hospitals, Boston ; Lou^s K. Diamond, 
M.D., Assistant Professor of Pediatrics, Harvard Medical 
School, Visiting Physician and Hematologist, Infants’ and 
Children’s Hospitals, Boston. With illustrations by C. Mer- 
rill Leister. M. D., Associate Pediatrician, St. Luke’s Hos- 
pital, Bethlehem and Allentown General Hospital, Allentown, 
Pennsylvania. The Commonwealth Fund. New York, 1944. 
Price. $12.00. 

PRINCIPLES AND PRACTICE OF SURGERY— By W, Wayne 
Babcock, M.D., Emeritus Professor of Surgery, Temple 
University, Acting Consultant, Philadelphia General Hos- 
pital : with the collaboration of thirty-seven members of the 
faculty of Temple University. Lea & Febiger, Philadelphia, 
19-44. Price, $12.00. 


THE 1944 YEAR BOOK OF GENERAL MEDICINE— Edited 
by George F. Dick, M.D., J. Burns Amberson, M.D., George 
R. Minot, M.D., William B. Castle, M.D., William D. Stroud, 
M.D., and George B. Eusterman, M.D. The Year Book 
Publishers, Chicago, 1944. Price, $3.00. 

OPERATIONS OF GENERAL SURGERY— By Thomas G. Orr, 
M.D., Professor of Surgery, University of Kansas School of 
Medicine, Kansas City, Kansas. W. B. Saunders Company, 
Philadelphia, 1944. Price, $10.00. 

MODERN CLINICAL SYPHILOLOGY — By John H. Stokes, 
M.D., Professor of Dermatology and Syphilology, School of 
Medicine and Graduate School of Medicine, University of 
Pennsylvania : Herman Beerman, M.D., Assistant Professor 
of Dermatology and Syphilology, School of Medicine and 
Graduate School of Medicine, University of Pennsylvania; 
and Norman R. Ingraham, Jr., M.D., Assistant Professor 
of Dermatology and S 5 T>hilology, School of Medicine, Uni- 
versity of Pennsylvania. Third edition, reset. W. B. Saun- 
ders Company. Philadelphia, 1944. Price, $10.00. 

SURGERY OF THE HAND — By Sterling Bunnell, M.D., honor- 
ary member of American Academy of Orthopedic Surgeons ; 
member of American Association of Plastic Surgeons and of 
American Society of Plastic and Reconstructive Surgery. 
J. B. Lippincott Company, Philadelphia, 1944. Price, 812.00. 

THE ART OF RESUSCITATION— By Paluel J. Flagg. M.D., 
Chairman, Committee on Asphyxia, American Medical As- 
sociation ; President and Founder of the Society for the Pre- 
vention of Asphyxial Death, Inc. Reinhold Publishing Cor- 
poration, New York, 1944. Price, $5.00. 


REVIEWS 


ROOK 

ARTHRITIS AND ALLIED CONDITIONS 

By Bernard I. Comroe, M.D., Associate in 
Medicine, University of Pennsylvania, Sen- 
ior Ward Physician and Chief of the Arthri- 
tis Clinic, Hospital of the University of 
Pennsylvania. Third edition, enlarged and 
thoroughly revised. Lea & Febiger, Phila- 
delphia, 1944. Price, $12.00. 

This book of 1,360 pages is, in my opinion, one of 
the few books which should be not only in the library 
of every physician but on his desk for continuous 
study. The book is thoroughly written, reviewing in 
detail all of the multiple phases of arthritis in its 
connections to all anatomic and physiologic phases 
of medicine and surgery. The glands, circulation, 
nervous system, bones, joints, muscles, digestion, 
all have their marked influence upon arthritis. The 
book, as written, could and should be of daily vital 
interest to orthopedists, general practitioners, sur- 
geons and pediatrists, as well as to internists. The 
practitioner of every branch of medicine daily sees 
his quota of arthritic individuals. 

The text is complete in every divergent detail yet 
it has outlines, framed in heavy black, for quick 
reference for today’s busy practitioner. The author 
outlines in detail all modes of treatment and frankly 
states their value or lack of value. The chapter on 
penicillin is easily worth the price of the book. 

Chapter LXIH, pages 1,282 to 1.298 briefs 238 
mistakes in the handling of arthritis. If every 
practitioner memorized these 238 mistakes, the 
treatment of arthritis would be considerably im- 


proved. If this brief chapter were published in small 
book form it would be worth the cost of the present 
book. 

The last chapter “Recent Advances in Arthritis” 
brings up to date this scholarly review of this most 
excellent volume. 

I strongly urge its widespread and continuous 
use. F. L. K. 


HANDBOOK OF NUTRITION 

A symposium prepared under the auspices 
of the Council on Foods and Nutrition of 
the American Medical Association. Ameri- 
can Medical Association, Chicago, 1943. 
Price, $2.50. 

This book is a compilation of articles published in 
the Journal of the American Medical Association. 
Each of the twenty-eight contributing writers is well 
known and distinguished in the field of medicine, 
biochemistry, and nutrition, thus the information is 
accurate and authoritative. 

The first chapters in the book cover such subjects 
of basic nutrition as the specific nutrients and re- 
quirements of each, the distribution of these nu- 
trients in food, their preservation in food processing, 
and the recommended dietary allowance of each. 
Feeding special groups, the evaluation of the Ameri- 
can nutritional status, and nutrition in preventive 
medicine, as well as principles of diet in the treat- 
ment of disease, are included. 

This book has been written for the practicing phy- 
sician and is an excellent reference. L. A. S. 


VoL. XXXV. No. 2 


Journal of Iowa State Medical Society 


73 


THE 1944 YEAR BOOK OF GENERAL MEDICINE 

Edited by George F. Dick, M.D., J. Burns 
Amberson, M.D., George R. Minot, M.D., 
William B. Castle, M.D., William D. Stroud, 
M.D., and George B. Eusterman, M.D. The 
Year Book Publishers, Chicago, 1944. Price, 
$3.00. 

Every doctor should have and read this book. 
First, because of rapid advances in medicine we 
need the material presented; and second, it is a pleas- 
ure, not a chore. Again this year it stresses mili- 
tary and tropical medicine, which is something most 
of us need to review. New theories and treatments 
of pneumonia, tuberculosis, blood transfusions and 
their substitutes, heart diseases, the gastro-intesti- 
nal system, and nutrition are all well reviewed in a 
concise manner. The “Quiz Section” is stimulating 
and presents readily assimilable, newer knowledge 
in an enjoyable manner. C. A. N. 


CONTROL OF PAIN IN CHILDBIRTH 

By Clifford B. Lull, M.D., Clinical Profes- 
sor of Obstetrics, Jefferson Medical College, 
Assistant Director, Philadelphia Lying-in 
Unit, Pennsylvania Hospital; and Robert A. 
Hingson, M.D., Surgeon, U. S. Public 
Health Service, Director, Postgraduate Med- 
ical Course, Philadelphia, Lying-in Unit, 
Pennsylvania Hospital. With an introduc- 
tion by Norris W. Vaux, M.D., Obstetrician- 
in-Chief, Philadelphia Lying-in Unit, Penn- 
sylvania Hospital. J. B. Lippincott Com- 
pany, Philadelphia, 1944. Price $7.50. 

This book, written by two recognized authorities 
in their respective fields of obstetrics and anesthe- 
siology, comprises a most complete and certainly the 
most recent information on the status of anesthesia 
and analgesia in childbirth. The text is divided into 
three parts. Part one deals with the anatomy of 
the organs of parturition and the physiopharmacol- 
ogy of the agents and technics used for the relief of 
pain during childbirth. Part two deals with the 
technics associated with the use of the agents and 
gives also pertinent features of the third stage of 
labor and the puerperium which may be directly or 
indirectly influenced by the anesthesia or analgesia 
employed. Part three considers the special difficul- 
ties accompanying the production of anesthesia 
and analgesia in the gravid patient with complica- 
tions. The prevention and treatment of asphyxia 
neonatorum and a discussion of other factors direct- 
ly related to the haby complete the book. 

It will be evident to the well informed and dis- 
cerning reader that the sections of the book devoted 
to inhalation and intravenous agents and technics 
are written by individuals whose information on 
these agents and technics was obtained more from 
thorough perusal of the literature than from abun- 
dant proficient use of the drugs and methods. The 
sections devoted to infiltration, regional and spinal 
technics are rational, complete, and replete with evi- 


dence of a thorough understanding of fhe possibili- 
ties and limitations of these drugs and procedures. 
Beautiful and generous illustrations serve to expe- 
dite and simplify the appreciation of the material. 
The inordinate emphasis on the use of continuous 
caudal for the relief of pain at delivery is easily un- 
derstood and perhaps excusable for authors who 
have put forth considerable effort in reviving and 
promoting this old and quite satisfactory technic. 

The authors significantly point out that the most 
satisfactory use of the material in the book will be 
by the cooperative team of trained obstetrician and 
anesthesiologist. This emphasizes the fact that the 
safest and most efficient anesthesia and analgesia 
for the relief of pain during childbirth is primarily 
dependent on the ability of the anesthesiologist to 
apply the anatomic and physiopharmacologic prin- 
ciples and not merely on his knowledge of those 
principles. The trained obstetrician and anethesi- 
ologist will be familiar with the material contained 
in this volume but its concise organization may prove 
useful. The book will be of interest to the gen- 
eral practitioner and student who wish to enlarge 
their understanding of the fundamental problems 
associated with this aspect of anesthesiology. It 
is likely that the authors will regret the use of the 
book as a manual by the neophyte anesthesiologist 
and obstetrician. S. C. C. 


TABOR’S DICTIONARY OF GYNECOLOGY 
AND OBSTETRICS 

By Clarence Wilbur Taber, Medical Editor 
and author of Taber’s Cyclopedic Medical 
Dictionary, Taber’s Condensed Medical Dic- 
tionary, and Dictionary of Food and Nutri- 
tion; with the collaboration of Mario A. 
Castallo, M.D., Assistant Professor of Ob- 
stetrics, Jefferson Medical College, Gynecol- 
ogist to St Mary’s and St. Agnes Hospitals, 
Obstetrician to St. Mary’s Hospital. F. A. 
Davis Company, Philadelphia, 1944. Price, 
$3.50. 

Upon glancing through this book one realizes by the 
illustrations that the emphasis is on gynecology and 
obstetrics. Upon a more detailed examination one 
becomes bewildered by the mass of irrelevant ma- 
terial such as directions for removing grass stains 
and chocolate from clothing and tables of the “av- 
erage blood pressure of old men and old women, 65 
to 90.” Three full pages are devoted to sputum. 
Some gynecologic definitions are inadequate and in- 
correct. Four full pages are devoted to “symp- 
toms” but no gynecologic or obstetric symptoms 
are given. 

Treatments suggested are sometimes unusual. 
Are treatments usually given in dictionaries? 

An attempt has been made to bring it up to date 
by giving a lengthy discussion on the sulfonamides, 
yet the antiseptics for skin are given as alcohol, 
sulfur and icthylol. 

The book cannot be recommended for physicians, 
nurses, or laymen. A. M. B. 


74 


Journal of Iowa State Medical Society 


February, 1945 


SOCIETY PROCEEDINGS 


Black Hawk County 

The regular monthly meeting of the Black Hawk 
County Medical Society was held in Waterloo at 
Black’s Tea Room Tuesday, January 16, at 6:30 
p. m. The guest speaker of the evening was Lieu- 
tenant Rex B. Foster, dental officer at the WAVE 
Training Center in Cedar Falls and a former dentist 
of Waterloo, who spoke on his experiences as dental 
surgeon on the hospital ship U. S. S. Solace. He 
illustrated his discussion with lantern slides of war 
casualties whom he cared for aboard his ship. 

At the Society’s annual meeting in' December Dr. 
Burr C. Boston was named president-elect; Dr. 
Harold 0. Gardner, vice president; Dr. Sterling A. 
Barrett, secretary; Dr. George C. Murphy, treasurer; 
Dr. F. Harold Entz, trustee; Dr. Emery E. Magee, 
delegate; Dr. Boston, alternate; and Dr. John L. 
Kestel, censor. Dr. Henry A. Bender was installed 
as president, having been chosen president-elect last 
year. All officers are of Waterloo. 

H. a. Bender, M.D., President 


Clarke County 

The postponed meeting of the Clarke County Medi- 
cal Society was held Wednesday evening, January 
17, in conjunction with the dinner of the Osceola 
Rotary Club. The program consisted of a discussion 
of Socialized Medicine by Albert L. Yocum, M.D., and 
a review of the Iowa Medical Service Plan by Roy C. 
Gutch, M.D., both of Chariton. The program was 
thought-provoking and was discussed favorably by 
lay members both during and after the meeting. 

All members of the Society were present and also 
several guests from adjoining territories. Following 
the Rotary dinner a business meeting of the Society 
was held and the following officers elected for 1945: 
Dr. Frederick S. Bowen of Woodburn, president; Dr. 
Herbert E. Stroy of Osceola, vice president; Dr. 
Conreid R. Harken, secretary-treasurer; Dr. Harken, 
delegate; and to the Board of Censors, Dr. Bowen 
for three years. Dr. William F. Dean of Osceola for 
two years, and Dr. Stroy for one year. 

C. R. Harken, M.D., Secretary 


Clinton County 

The Clinton County Medical Society held its first 
meeting of the year at the Elks Club in Clinton, 
Thursday, January 18, with dinner at 6:30 p. m. 
Officers elected for 1945 were Dr. Robert E. Dwyer 
of Clinton, president; Dr. Leander H. Schafer of De- 
Witt, vice president; and Dr. Joseph E. O’Donnell of 
Clinton, secretary-treasurer. Hubert K. Knudsen, 
M.D., of Clinton, conducted a roundtable discussion 
on X-Ray Therapy of Infections and Inflammatory 


Conditions. Guests included officers from Schick 
General Hospital and visitors from surrounding 
towns. 


Dubuque County 

Officers elected to serve the Dubuque County Medi- 
cal Society during 1945 include Dr. Howard E. 
Thompson, president; Dr. Matthew J. Moes, first vice 
president; Dr. Frank J. Bries, second vice president; 
Dr. Joseph W. Lawrence, secretary; Dr. Harry A. 
Stribley, treasurer; Dr. J. Carl Painter, delegate; 
and Dr. John A. Thorson, alternate. All officers are 
of Dubuque with the exception of Dr. Bries who is 
located in Holy Cross. 


Jasper County 

At a recent meeting of the Jasper County Medi- 
cal Society Dr. Raymond F. Freeh was re-elected i 
president of the group. Other officers re-elected ; 
were Dr. Leon P. Adams, vice president; and Dr. 
Thomas D. Wright, secretary-treasurer. All officers 
are of Newton. 


Johnson County 

The Johnson County Medical Society held its 
regular monthly meeting in Iowa City at the Hotel 
Jefferson Wednesday, January 3, at 6:00 p. m. The 
usual business meeting was held following dinner, 
with inauguration of the new officers. The scientific 
program consisted of a discussion of Some Newer 
Developments in Skin Grafting. The report covered 
work done at the University Hospitals in the De- 
partments of Pathology and Surgery; Emory D. 
Warner, M.D., presented the pathologic aspects and 
Robert T. Tidrick, M.D., discussed the clinical 
aspects. g jj Flocks, M.D.. Secretary 


Monona County 

A meeting of the Monona County Medical Society 
was held in Onawa at the Royal Cafe Friday even- 
ing, December 15. Dr. Edward J. Liska of Ute was 
elected president of the Society for 1945 and Dr. 
Earl E. Gingles of Onawa, secretary-treasurer. 
Checks were sent as Christmas gifts to the Monona 
County doctors in military service. 


Palo Alto County 

The annual winter meeting of the Palo Alto 
County Medical Society was held in Emmetsburg at 
the McNutt Tea Room Thursday evening, January 
11. The business meeting and scientific program 
were held in the hospital parlors. 


VoL. XXXV, No. 2 


Journal of Iowa State Medical Society 


75 


Polk County 

The annual meeting of the Polk County Medical 
Society was held in Des Moines at the Des Moines 
Club Wednesday, January 17, at 6:30 p. m. Election 
of officers was held following dinner and those named 
were Dr. Martin I. Olsen, president-elect; Dr. Edward 
W. Anderson, secretary-treasurer; Dr. Malcolm A. 
Royal, trustee; Dr. James A. Downing, councilor-at- 
large; Drs. John C. Parsons, Lee F. Hill, Clifford W. 
Losh, Russell C. Doolittle and William R. Hornaday, 
delegates; and Drs. Christian B. Luginbuhl, Alonzo 
L. Jenks, Jr., Abraham G. Fleischman, Lewis M. 
Overton, and Harold C. Black, alternates. Dr. Arthur 
E. Merkel, who has been president-elect, assumed 
office for the current year. All officers are of Des 
Moines. 

The guest speaker of the evening was Mr. Vincent 
Starzinger, General Counsel for the Register and 
Tribune Company, who presented an excellent ad- 
dress entitled A Proposal of Marriage. The Honor- 
able Robert D. Blue, Governor of Iowa, and John 
MacVicar, Mayor of Des Moines, also spoke briefly. 


Tama County 

Members of the Tama County Medical Society met 
in the Traer Library for a business meeting Friday 
evening, January 5, following a dinner at the Please- 
U Cafe at 6:30 p. m. Officers elected for 1945 were 
Dr. Gilbert T. McDowall of Gladbrook, president; 
Dr. Arthur A. Pace of Toledo, vice president; Dr. 
Glenn M. Dalbey of Traer, secretary-treasurer; and 
Dr. Frederick W. Gessner of Dysart, delegate. 


Wapello County 

The February meetings of the Wapello County 
Medical Society will be held on the sixth and 
twentieth of the month. The meeting Tuesday, Feb- 
ruary 6, will be at St. Joseph Hospital and the 
program will consist of a film entitled Indirect In- 
guinal Hernia, which includes the surgical anatomy, 
clinical aspects, and operative repair of hernia. The 
guest speaker at the meeting Tuesday, February 20, 
will be Ira Nelson Crow, M.D., of Fairfield, who will 
discuss Tumors of the Eye. This meeting is also 
scheduled to be held at St. Joseph Hospital. 


Woodbury County 

The annual meeting of the Woodbury County 
Medical Society was held in Sioux City at the Martin 
Hotel Thursday evening, January 11. _ Dr. Charles A. 
Katherman, who has been president-elect of the 
Society, assumed office of president. Dr. Clifford 
R. Watkin was chosen president-elect and will suc- 
ceed Dr. Katherman in 1946. Also elected was Dr. 
Farnk D. McCarthy as secretary-treasurer-elect. Dr. 
Roland T. Rohwer, who has been secretary-treasurer- 
elect, assumed office for the current year. 


PERSONAL MENTION 

Dr. Harry E. Nelson of Dayton completed fifty 
years of active practice in that city on December 
20. Dr. Nelson first located in Lehigh where he 
practiced for a year and a half before moving to 
Dayton on December 20, 1864. 


Dr. Helge Borre, who has practiced in Emerson for 
the past six years, has moved to Red Oak and opened 
offices in the Montgomery County National Bank 
Building. 


Dr. John L. Klein, Jr., of Muscatine spoke before 
the Twentieth Century Club of that city Tuesday 
evening, January 9, at the home of one of the mem- 
bers. Dr. Klein discussed New Advances in Medi- 
cine. 


Dr. George L. Venable, who has practiced in New 
Sharon for the past twenty-five years, has moved 
to North Manchester, Indiana, where he will con- 
tinue in the practice of medicine. 


Dr. Wilson C. Wolfe has resumed his practice in 
Ottumwa after ten months of active duty in the 
United States Naval Reserve. Dr. Wolfe, who served 
in the Navy as a Lieutenant, junior grade, has been 
given a medical discharge. 


Dr. John A. Thorson of Dubuque addressed the 
Kiwanis Club of that city at its meeting Tuesday 
noon, January 16. The subject of his talk was A 
Doctor’s Viewpoint on Politically Controlled Medi- 
cal Practice. 


Dr. Albert I. Haugen, who has practiced in Ames 
since 1930, is moving to Los Angeles, California, 
where he is to be associated with a staff of physicians 
in a clinic. 


Dr. A. Fred Watts has moved to Seattle, Washing- 
ton, to form a partnership with an established 
physician there. Dr. Watts has been located in 
Creston since 1920. 


The American College of Surgeons has notified 
the Journal that the following Iowa physicians 
were accepted into fellowship in the College in 1944: 
Drs. James W. Agnew of Iowa City, Robert N. 
Bartels of Iowa City, Edward L. Besser of Iowa City, 
William G. Bessmer of Davenport, William E. Cody 
of Sioux City, Roger R. Flickinger of Mason City, 
Rubin H. Flocks of Iowa City, Arthur A. Garside of 
Davenport, Theodore J. Greteman of Iowa City, Carl 
H. Matthey of Davenport, and Wade O. Preece of 
Waterloo. 

Dr. W. Norman Doss of Leon recently spoke be- 
fore the Rotary Club of that city. Dr. Doss chose 
Diagnosis as the topic of his discussion. 


76 


Journal oi' Towa Statl. Mkdical Society 


MARRIAGE 

Mrs. Jessie Weese and Dr. Frank W. Fordyce, both 
of Des Moines, were united in marriage Wednesday 
evening, December 27, in the chapel at Central 
Presbyterian Church in Des Moines. The couple is 
at home in the Wetherell Apartments, 4024 Grand 
Avenue. Dr. Fordyce has been practicing- in Des 
Moines for several years. 


DEATH NOTICES 

Bowen. William W., of Fort Dodge, aged seventy- 
five, died December 20 following a brief illness. He 
was graduated in 1895 from the State University of 
Iowa College of Medicine, and had long- been a mem- 
ber of the Webster County and Iowa State Medical 
Societies. A more complete obituary will be found 
in the History of Medicine section of ^his issue. 


Lacey, Thomas Bigelow, of Glenwood, aged sixty- 
four, died December 29 after an illness of several 
months. He was graduated in 1906 from Creighton 
University School of Medicine, and at the time of 
his death was a member of the Mills County and 
Iowa State Medical Societies. 


Magoun, Charles Elmer, formerly of Sioux City, 
aged fifty-six, died December 22. He was graduated 
in 1915 from Middlesex University School of Medi- 
cine in Waltham, Massachusetts, and at the time of 
his death was a member of the Woodbury County 
and Iowa State Medical Societies. 


Nervig, Isaac Eugene, of Sioux City, aged seventy, 
died December 24 following a long illness. He was 
graduated in 1902 from the State University of Iowa 
College of Medicine, and had long been a member of 
the Woodbury County and Iowa State Medical So- 
cieties. 


Wright, Charles Edward, of Clear Lake, aged 
eighty-three, died December 21 after an illness of 
a few weeks. He was graduated in 1898 from the 
State University of Iowa College of Medicine, and 
at the time of his death was a member of the Cerro 
Gordo County and Iowa State Medical Societies. 


Baker, Robert Ward, of Davenport, aged 
twenty-eight, died in England of virus pneu- 
monia which he contracted while serving as a 
Captain in the Medical Corps of the Army of 
the United States. He was graduated in 1940 
from the State University of Iowa College of 
Medicine, and at the time of his death was a 
member of the Scott County and Iowa State 
Medical Societies. 


February, 1945 

MEDICAL HISTORY OF WAPELLO COUNTY 

(Continued from paj?e 71) 

sixty years ago, and the exeinjdary manner in 
which they set about to achieve their |)urjx)ses, is 
recorded in the Iowa State Medical Reporter for 
the year 1884. 

Here it is, a classical record of inspiration and 
achievement : 

MEETING OE THE WAPELLO COUNTY MEDICAL 
SOCIETY 

“The regular monthly meeting was held at the 
office of Drs. O’Neil and Hyatt, Tuesday, Feb- 
ruary 5th, 1884. Dr. L. J. Baker, president, in 
the chair. 

“Minutes of last meeting read and apiiroved. 

“On favorable report of Board of Censors, Dr. 
F. M. Arenschild, of Eldon, was made a member. 

“By request of Society, Dr. L. J. Baker read a 
paper on sanitation, during discussion of which it 
was stated that the supply of river w-aters was 
contaminated by slaughter-houses above the city. 

“Drs. Thrall, Hinsey and Hyatt were appointed 
a committee to prepare a Memorial to the city 
council regarding the contamination of our water 
supply, said Memorial to he submitted to this So- 
ciety at its next meeting. 

“On motion of Dr. Thrall, the secretary was au- 
thorized to forward each month, to the State Medi- 
cal Reporter, a synopsis of the proceedings of this 
society * * * Dr. Alice M. Stark was appointed 
to prepare a paper for the next meeting in Mav. 

“Society adjourned. 

S. A. Spihnan, Secretary.” 

(To be Continued) 


SPRING REFRESHER COURSE IN 
OTOLARYNGOLOGY 

The fifth semi-annual refresher course in laryn- 
gology, rhinology, and otology will be conducted by 
the University of Illinois College of Medicine in Chi- 
cago, March 26 to 31 inclusive. While the course 
will be largely didactic, some clinical instruction will 
be included. This course is intended primarily for 
ear, nose, and throat specialists. Since the registra- 
tion is limited to thirty, applications will be consid- 
ered in the order in which they are received. The 
fee is $59.00-.-- When^ writing for. application, please 
give details concerning school, year of graduation, 
and past training and experience. Address Dr. A. 
R. Hollender, Chairman, Refresher Course Commit- 
tee, Department of Otolaryngology, University of 
Illinois, College of Medicine, 1853 West Polk Street, 
Chicago 12, Illinois. 



(H. 

Presibtmt 

^loitJii ,^tate ^'ocicta 


1944-1945 


The JOURNAL 


Iowa State Medical Society 



* I 





""" 

"•••rimiimmu.. 

VoL. XXXV 

Des Moines, Iowa, March, 1945 




No. 3 



iiimiiMiiiiiniiiiMniiiMiiuMiiiMHnM 







.Mi 


STATE MEDICAL SOCIETY 

Organized in 1850 

NOTICE OF CANCELLATION 

of 


Ninety-Fourth Annual Session 

T ▼ T 

PRESIDENT’S STATEMENT 


To the Membership: 

This statement is notice to you of the cancella- 
tion of the annual scientific program of the Iowa 
State Medical Society which was scheduled to be 
held in Des Moines April 19 and 20, 1945. The 
cancellation is in compliance with the request of 
the Office of Defense Transportation to dispense 
with all meetings of over fifty persons in further- 
ance of the country’s war effort. 

As your President, I must confess this cancella- 
tion was made with a little regret. However, this 
regret is more than offset by my pride in the mem- 
bership of the Iowa State Medical Society which 
again, as has always been the case, is cooperating 
to the fullest extent with our Government in all 
emergencies, regardless of the cost. 

I think you are entitled to know that everyone 
connected in any way with preparing the contem- 
plated program has functioned one hundred per 
cent, and that all arrangements, with the exception 
of a few minor details, were complete for pre- 
senting the program to the membership. I wish 
at this time to thank the section chairmen for their 
untiring efforts in arranging the scientific pro- 
gram. These chairmen, Dr. Horace M. Korns 
for medicine, Dr. Gerald V. Caughlan for surgery. 
Dr. Wayland H. Maloy for eye, ear, nose and 
throat, not only invited the various essayists to 
appear, but since cancellation, have arranged with 
the essayists to furnish their papers for publication 
in the Journal during the year in lieu of their 


])ersonal appearances at the meeting. You will 
find the program on the following page. 

I am also grateful to Dr. James A. Downing 
and Dr. Lewis M. Overton for the work they have 
done in preparing for the scientific moving picture 
section and the scientific exhibit section. 

I wish to thank the central office and all those 
who assisted in arranging for the commercial 
exhibits, as well as the many exhibitors who had 
purchased space. The work for this section has 
had to he undone and the money refunded, which 
means a financial loss to the Society. 

HOUSE OF DELEGATES 

Please do not interpret this statement to mean 
that the annual meeting of the House of Delegates 
has heeu canceled. I am not able, at this writing, 
to give you any definite information about this 
meeting because there are legal technicalities which 
make it impossible to make a decision at this time. 
I do wish to assure you that your officers are en- 
deavoring to arrange for the House of Delegates 
so that we may follow the intent of our Constitu- 
tion and corporate structure. As soon as expected 
rulings are received from Washington, the decision 
will he made and you will he notified at the first 
possible moment. 



78 


Journal of Iowa State Medical Society 


March, 1945 


PROPOSED SCIENTIFIC PROGRAM 



M. C. Hennessy, M.D., Council Bluffs, President 

Medicine and Medical Education in the Postwar Era 
Ewbn M. MacEwen, M.D., Dean, College 
of Medicine, State University of Iowa, 
Iowa City 

Role of the Sanatorium in the Postwar Period 

William M. Spear, M.D., Superintendent, 
State Sanatorium, Oakdale 

Postwar Care of the Mentally 111 in the State 
Hospitals 

Charles F. Obermann, M.D., Medical 
Superintendent, Cherokee State Hospital, 
Cherokee 

One Man’s Opinion 

M. C. Hennessy, M.D., President, Iowa 
State Medical Society, Council Bluffs 



Horacb M. Korns, M.D., Iowa City, Chairman 
Amebiasis 

Willis M. Fowler, M.D., Associate Pro- 
fessor Theory and Practice of Medicine, 
College of Medicine, State University of 
Iowa, Iowa City 

Moving Picture on Malaria 

Milford E. Barnes, M.D., Professor of 
Hygiene and Preventive Medicine, College 
of Medicine, State University of Iowa, 
Iowa City 

Blackwater Fever 

Ricardo Castaneda, M.D., College of 
Medicine, State University of Iowa, Iowa 
City 

Malaria in Returning Servicemen 

Colonel Paul F. Russell, M.C., Chief, 
Parasitology Division, Army Medical 
School, Army Medical Center, Washing- 
ton, D. C. 

Chinese Native Ophthalmology 

Otis S. Lee, M.D., College of Medicine, 
State University of Iowa, Iowa City 



Gerald V. Caughlan, M.D., Council Bluffs, 
Chairman 

Renal Stone 

Rubin W. Flocks, M.D., Associate Pro- 
fessor of Urology, College of Medicine, 
State University of Iowa, Iowa City 


Penicillin in the Treatment of the Urinary Tract 

Major Edward M. Honke, M.C., Tomey 
General Hospital, Palm Springs, Cali- 
fornia 

One Stage Suprapubic Prostatectomy with Primary 
Bladder Closure 

Clifford W. Losh, M.D., Des Moines 

Cancer of the Prostate Gland: Treatment with Spe- 
cial Reference to Stilbestrol and Castration 

Lawrence E. Pierson, M.D., Sioux City 

The Management and Care of a Patient with a 
Colostomy 

Louis E. Moon, M.D., Associate Professor 
of Surgery, Creighton University School 
of Medicine, Omaha, Nebraska 



Wayland H. Maloy, M.D., Shenandoah, Chairman 


Control of Hemorrhage 

Paul G. Moore, M.D., Assistant Clinical 
Professor of Ophthalmology, Western Re- 
serve University School of Medicine, 
Cleveland, Ohio 

Headaches, Dizziness and Nosebleed 

Thomas R. Gittins, M.D., Sioux City 

Uses of Penicillin in Ophthalmology and 
Otolaryngology 

Cecil C. Jones, M.D., Des Moines 

Rehabilitation of the Blind and Deaf 

Charles E. Chenoweth, M.D., Mason 
City 

Symposium on Neoplasms of the Larynx: 

Anatomic Aspects 

Eugene W. Scheldrup, M.D., Associate 
Professor of Anatomy, College of Medi- 
cine, State University of Iowa, Iowa City 

Pathologic Aspects 

Emory D. Warner, M.D., Associate Pro- 
fessor of Pathology, College of Medicine, 
State University of Iowa, Iowa City 
Diagnosis, Symptoms and Examination 

Paul G. Moore, M.D., Assistant Clinical 
Professor of Ophthalmology, Western Re- 
serve University School of Medicine, 
Cleveland, Ohio 
Treatment 

Dean M. Lierle, M.D., Professor of Oto- 
laryngology, College of Medicine, State 
University of Iowa, Iowa City 
Speech Training in Laryngectomized Patients 

Dr. C. R. Strother, Department of 
Speech, State University of Iowa, Iowa 
City 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


79 


POLYCYTHEMIA VERA* 

Lieutenant Commander Robert A. Towle, 
M.C., U.S.N.R., 

Captain Forest H. Coulson, M.C., A.U.S., 
and Willis M. Fowler, M.D., Iowa City 

Polycythemia vera is a relatively rare disease 
of the hematopoietic system but recent reports, in 
stressing particularly the great variety of clinical 
manifestations of the disease and the frequency 
with which it is confused with other diseases, have 
suggested that many of these cases pass unrecog- 
nized. This is especially true in the early stages 
when symptoms may be present before the char- 
acteristic changes in the blood make their appear- 
ance. The incidence of the disease may therefore 
be greater than is commonly believed. In contrast 
to those patients in whom there are early subjec- 
tive manifestations, there are others in whom the 
disease is recognized by the characteristic blood 
picture which is found on a routine blood examina- 
tion, the patient having had no significant symp- 
toms referable to the polycythemia. 

The disease was first described by Vaquez in 
1892, but Osier’s^’ ^ descriptions in 1903 and 1904 
brought it to the attention of physicians so that 
reports and discussions of the disease have ap- 
peared in increasing numbers since that time. The 
etiology of the disease has remained a mystery, 
most observers believing that it is comparable to 
leukemia and is probably neoplastic in origin. 
Reznikoff^ has suggested that a thickening of the 
walls of the small vessels in the bone marrow may 
so interfere with the liberation of oxygen that 
anoxia of the erythropoetic centers develops and 
acts as a stimulus to cause an increased production 
of erythrocytes. Other workers have been unable 
to demonstrate consistently the vascular changes 
which he describes. 

The salient features on which the diagnosis is 
based are the hematologic findings, consisting of 
an elevated erythrocyte count, hematocrit, and 
hemoglobin level. A leukocytosis with a nuclear 
shift to the left is usually present and the plate- 
lets are increased in most instances. As evidences 
of the hyperplasia and overactivity of the bone 
marrow there are polychromatophilia and occasion- 
al nucleated erythrocytes in the peripheral blood 
stream. The total blood volume is increased and 
this is due predominantly to an increase in red 
cell mass.^ There is little or no increase in the 
volume of the plasma. The increase in the red 
cell mass produces a marked increase in the vis- 
cosity of the blood, commonly to four or five 
times the normal value, and an increase in the 

*From the Department of Internal Medicine, State University 
of Iowa. 


specific gravity of the blood to 1.075 or 1.080 as 
compared to normal values between 1.055 to 1.065. 
This increased viscosity of the blood together with 
the great increase in blood volume causes a slug- 
gishness of blood flow, and distention and tortuos- 
ity of the capillary vessels, particularly of their 
venous segments. Engorgement of the vascular 
bed and slowing of the blood flow in turn ac- 
count for many of the patient’s symptoms as well 
as for the fact that spontaneous thromboses of 
the vessels and hemorrhages are frequent clinical 
features. Although hemorrhages are common, the 
bleeding time and coagulation time are normal, the 
platelets are usually increased in number, and 
upon attempting venesection great difficulty may 
be encountered because the blood coagulates so 
readily. The hemorrhagic tendencies in these pa- 
tients are secondary to the intense engorgement 
and distention of the vessels. Thrombosis of the 
coronary and cerebral vessels are common events, 
and occasionally mesenteric thrombosis occurs re- 
sulting in abdominal pain suggestive of an acute 
abdominal condition requiring surgical interven- 
tion. Thrombosis of the vessels of the extremities 
may produce a picture simulating thrombo-angiitis 
obliterans or erythromelalgia.*^ 

Before a diagnosis of polycythemia vera can 
be made, it is necessary to exclude those diseases 
in which a secondary polycythemia may occur. 
These include those chronic cardiac or pulmonary 
diseases in which there is improper oxygenation of 
the blood or interference with the gaseous ex- 
change resulting in anoxemia which serves to stim- 
ulate erythrocyte production. This is seen in 
congenital heart lesions which are accompanied by 
cyanosis and occasionally in long standing ac- 
quired heart disease, especially mitral stenosis. 
Extensive pulmonary fibrosis or lesions of the pul- 
monary artery, such as sclerosis or syphilis, pro- 
duce a similar hematopoietic response. Polycythe- 
mia may also accompany tuberculosis or syphilis 
of the spleen or extensive thrombosis of the portal 
and splenic vessels. 

Polycythemia vera is a disease of late adult life 
and therefore occurs in the age period when ar- 
teriosclerosis and hypertension are particularly 
frequent, so that these conditions, together with 
cardiac hypertrophy, frequently coexist. It is 
difficult to evaluate the part played by the poly- 
cythemia in bringing about vascular disease. In 
view of Atschule’s findings,® however, cardiac hy- 
pertrophy and hypertension are probably coexist- 
ing diseases rather than having a cause and effect 
relationship. He has shown that in uncomplicated 
polycythemia vera the cardiac output, cardiac work, 
and the venous pressure are normal. Dameshek’s® 
series of cases illustrates the fact that polycythe- 


80 


Journal of Iowa Statl Medical Society 


March, 1945 


niia vera may simulate cardiovascular or ]>eri]ih- 
eral vascular disease, disease of the central nervous 
or "astro-intestinal systems, arthritis, nephritis, 
or neurasthenia. Obviously the manifestations 
are extremely variable and may he referable to 
any s}'stem in the body."' •* 

The disease undoubtedly develo|)S very slowly, 
requiriu" many years to reach its jicak, liut there 
is no method of recognition before the hematologic 
features are fully developed. Even after symp- 
toms have become apparent it is frequently a mat- 
ter of years before they become severe enough 
to cause the jxitient to consult a physician. In this 
series of twenty-five consecutive cases in which 
the diagnosis of pol)^cythemia vera seemed to he 
established without question, the average duration 
of symptoms before medical advice was sought 
was three years. One patient had slight symp- 
toms for seven years, while the shortest duration 
of symptoms was six months. The course is ex- 
ceedingly slow and chronic, and a duration of ten 
or more years after the onset of symptoms is not 
uncommon. Some have gone for as long as fif- 
teen years, so that barring the occurrence of one 
of the serious complications the patient may ex- 
pect several years of comfortable existence. 

The present series of cases consists of five fe- 
males and twenty males. This is a higher per- 
centage of males than is usually encountered. The 
ages varied from thirty-six to seventy years, with 
an average of fifty-four years, and there was no 
significant difference in the ages of the female 
and the male patients. A majority of the patients 
were natural born Americans, but a few were of 
Scandinavian origin. None of the group was Jew- 
ish, which is in distinct contrast to the racial inci- 
dence observed in other localities.’^' ^ 

A majority of the patients had symptoms re- 
ferable to the central nervous system. Dizziness, 
especially on changing position, was the most fre- 
cpient complaint, but was followed closely in its 
incidence by headache. A sense of fullness and 
pressure in the head was occasionally encountered, 
while others complained of roaring in the ears, 
spots before the eyes, or fainting. A loss of 
memory and a mild sense of confusion were noted 
by some. Several patients felt that after removal 
of blood by venesection their head felt clearer and 
they were more alert, although prior to treatment 
they had not noticed the presence of these symp- 
toms. The more serious of the cerebral manifes- 
tations consist of thrombosis of cerebral vessels 
with the hemiplegia or other manifestations of 
cerebral accidents. This may be the terminal 
event, and it occurred in three of these 25 patients. 

Cardiac symptoms were a feature in eleven of 


the cases, the most freejuent being shortness of 
breath on exertion. The interpretation of these 
synqitoms is difficult since polycythemia occurs 
in the age group when arteriosclerotic changes are 
to be expected. In four instances there were clefi- 
nite evidences of arteriosclerotic heart disease, 
each having hypertension, cardiac hypertrophy, 
jieripheral arteriosclerosis and electrocardiograph- 
ic evklences of a damaged myocardium. One of 
these patients had repeated attacks of paroxysmal 
auricular flutter, two had angina of effort and a 
sense of precordial oppression, and in one instance 
coronary occlusion occurred. In the alisence of 
evidences of arteriosclerotic heart disease the 
symptoms referable to the heart were of a minor 
nature with only shortness of breath or palpitation 
being noted. The observations of Altschule show- 
ing that the cardiac work is not increased in un- 
complicated polycythemia vera suggest that the 
cardiac damage does not result from the ixilycy- 
themia alone. 

Symptoms referable to the gastro-intestinal tract 
were present in twelve of the patients but these 
consisted of relatively mild indigestion and dys- 
pepsia for the most part. In one instance a duo- 
denal ulcer was present and gastro-enterostomy 
was performed because of pyloric obstruction. In 
a second patient the symptoms were suggestive of 
peptic ulcer and one rather severe gastric hemor- 
rhage occurred although no ulcer could be demon- 
strated by roentgenograms. These patients had 
attacks of pain but never was it severe or per- 
sistent enough to suggest mesenteric thrombosis. 
In addition to the one patient with the duodenal 
ulcer which bled, there were others in whom less 
severe hemorrhage into the gastro-intestinal tract 
occurred, all manifest by melena without hema- 
temesis. 

Although symptoms of peripheral vascular dis- 
ease occurred in some patients, in no instance was 
the polycythemia complicated by thrombo-angiitis 
obliterans. In one instance pain in the calves of 
the legs was produced by walking and relieved by 
rest, and three patients complained of a severe 
burning sensation of the feet so that erythromelal- 
gia was suggested. Thrombosis of peripheral ves- 
sels occurred in three cases. In one there was 
thrombophlebitis of the superficial veins of the 
left thigh ; in one the left popliteal vein became 
thrombosed : and in the third the anterior tibial 
artery base became occluded and amputation of 
the foot was necessary. 

Hemorrhages occurred in nine patients. In 
four of these the bleeding occurred in the gastro- 
intestinal tract and in one a large spontaneous 
hematoma appeared in the right forearm. In the 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


81 


others there was a mild epistaxis or bleeding from 
the gums. 

Painful joints were found in six of the 25 
cases but in two of these there was evidence of 
extensive osteo-arthritis. One patient had gout, 
and in two instances recurrent attacks of arthritis 
simulating the chronic rheumatoid variety had 
been present for thirteen and thirty years respec- 
tively. In none of these patients could the joint 
pain be directly attributable to the polycythemia 
vera. In the remaining patient, recurring attacks 
of swelling and pain occurred which suggested 
repeated hemorrhages into the joint spaces. 

The most outstanding feature of the physical 
examination was the dusky red color of the face 
and mucous membranes. This peculiar color is 
not a true cyanosis but is due to the intense en- 
gorgement and distention of the capillary bed. 
Cyanosis develops readily in these patients because 
of the high hemoglobin concentration with the 
possibility of a large amount of reduced hemoglo- 
bin, but the bluish tint is lacking in the uncompli- 
cated case. The conjunctivae are congested, a lit- 
tle swollen, and lacrimation is profuse. The small 
skin capillaries and venules are distended and 
prominent, particularly over the nose, cheeks, and 
neck. V arious sized ecchymotic areas may be 
found and hematomas are frequently encountered. 

The spleen was enlarged in 19 (76 per cent) 
of the cases and varied from an organ which was 
barely palpable to one which extended a' hand’s, 
breadth below the costal margin. The liver was 
enlarged in eight (32 per cent) of the cases but in 
no instance was it markedly enlarged. The blood 
pressure was elevated in 15 (60 per cent) and in 
five of these there was cardiac hypertrophy. The 
highest blood pressure reading was 195/125 but 
in nine cases the reading was in the neighborhood 
of 170/110. Electrocardiographic changes were 
present only in those patients with arterioscler- 
otic heart disease and were of the type to be ex- 
pected in this disease. Definite evidences of ar- 
teriosclerosis of either the peripheral or retinal 
vessels were found in 14 of the patients. In addi- 
tion to these vascular changes, the fundi were fre- 
quently deep red in color and the veins markedly 
engorged. 

The erythrocyte counts in these patients ranged 
from 6,450,000 to 13,000,000 with 16 cases hav- 
ing 8,000,000 or more red cells. The hematocrit 
values were also high, being above 65 in 76 per 
cent of the cases, and 70 or above in 42 per cent. 
The highest value was 77. The hematocrit read- 
ing indicates the percentage of the total blood vol- 
ume made up of packed erythrocytes, and this fea- 
ture accounts for the increased viscosity and in- 


creased specific gravity of the blood, so that those 
having the highest hematocrit reading had the 
greatest vascular distention and slowest blood flow 
and therefore the most symptoms from the dis- 
ease. The hemoglobin values ranged from 17 to 
25.4 grams per 100 cubic centimeters of blood 
with 21 of the 24 untreated cases having 18 or 
more grams. The color index remained about 
normal or slightly below, as did the volume index. 

The leukocyte count was above 10,000 per 
cubic millimeter in 84 per cent of the series, the 
highest total count being 40,000. On the blood 
smear the percentage of neutrophils was increased, 
the number of non-segmented neutrophils was 
greater than normal and an occasional myelocyte 
was encountered. The greatest evidence of imma- 
turity of the cells was usually encountered in those 
patients with the highest total leukocyte count, al- 
though this did not always hold true since the 
patient with the highest percentage of myelocytes 
(6 per cent) had a leukocyte count of 19,300. 
Only an occasional nucleated erythrocyte was en- 
countered, but in 50 per cent of the patients on 
whom reticulocyte counts were made they were 
elevated above normal, the highest being 6.2 per 
cent. 

The platelets were increased in 15 of the 23 
cases in which platelet determinations were made, 
but there was no correlation between the increase 
of platelets and the height of the erythrocyte or 
leukocyte count. By volumetric determination 
there were flve cases with platelets above 2 per 
cent (normal 0.4 to 0.6 per cent), but spontaneous 
thromboses were no more frequent in those pa- 
tients with high platelet determinations than in the 
others. The clot retractility was usually absent 
or poor, a feature that is probably due to the 
excessively high hematocrit values. The bleeding 
time and coagulation time were usually normal and 
in only one instance was the fragility of the red 
cells increased. 

Basal metabolic rates were obtained in ten pa- 
tients and the results were within normal limits 
in all but two instances. These were -1-17 and 
-)-58 respectively. Albuminuria was present in 
eleven of the patients. 

Reports have appeared in the literature of 
cases of polycythemia vera which have ultimately 
developed features of myelogenous leukemia and 
other instances which developed a severe anemia. 
We encountered none in which myeloid leukemia 
developed, but one patient who received a large 
amount of irradiation ultimately developed an 
anemia of an aplastic type. This sixty-four year 
old patient was first seen in 1932 with 20.5 grams 
of hemoglobin. 10,830,000 erythrocytes, and 33,- 


82 


Journal of Iowa State Mfjjical Society 


March, 1945 


000 leukocytes. The hematocrit rea(lin»- was 77 
and the platelets, 2.5 per cent. From 1932 to 1935 
he was admitted to the hospital on twelve occa- 
sions and received x-ray therapy to^ the bones, 
usually 200 to 300 R to localized areas, so that he 
received a total of 7,900 R during that period. 
Fie was not seen for three years, but in 1938 he 
returned to the hospital with a blood hemoglobin 
of 4.6 grams, 2,100,000 erythrocytes, hematocrit 
reading 16, and 3,600 leukocytes. A differential 
count on the last admission showed 82 per cent 
lymphocytes, 11 per cent neutrophils, 4 per cent 
myelocytes, and 3 per cent blast cells. The plate- 
lets were 0.075 per cent, the clot non-retractile, 
and the bleeding time prolonged. This picture sug- 
gests aplastic anemia, but the myelocytes indicate 
myeloid stimulation. It is probable, that this 
resulted from the irradiation rather than from 
the polycythemia. 

Necropsy examination was performed on only 
one case in this series. The patient was admitted 
to the hospital because of severe headache, right 
hemiplegia, aphasia, and mental confusion. Labo- 
ratory studies showed an erythrocyte count of 10,- 
500,000, hematocrit reading 75, hemoglobin 24.5 
grams. He subsequently developed streptococcus 
infection of the throat followed by bronchopneu- 
monia and pulmonary edema. At autopsy the 
meningeal and pial vessels were distended and two 
cerebral vessels were thrombosed with areas of 
cortical softening to account for the neurologic 
findings. The bone marrow was hyperplastic with 
involvement of both the erythrocytic and leuko- 
cytic elements. No evidence of vascular thickening 
could be detected in the bone marrow. There was 
distention and congestion of the vascular system 
everywhere, with marked engorgement of the 
spleen, atrophy of liver cells, and congestion of 
the kidneys with no thickening of the vessel walls. 
There was a moderate degree of arteriosclerosis of 
the aorta. 

The treatment in these cases varied. In the 
earlier cases phenylhydrazine was used. Results 
of this therapy were slow in their appearance and 
less satisfactory than the methods now used. Vene- 
section, with removal of 500 cubic centimeters of 
blood each day or every other day until the ery- 
throcyte count and hematocrit reading approach 
normal values gives immediate subjective relief 
and lessens the danger of spontaneous thrombosis. 
Mental confusion, fullness of the head, and head- 
ache may be immediately relieved by this means, 
and the efficiency of the circulatory system is im- 
proved. This treatment by itself may result in pro- 
longed remissions. It has been stated that removal 
of blood results in a stimulation of the bone mar- 


row, but if Ibis occurs tlie degree of stimulation is 
incomseciuential ami does not contraindicate vene- 
section. This therapy is best combined with irra- 
diation to those bones which are active in hemato- 
poiesis : the proximal ends of the long bones, the 
sternum, ribs, vertebrae, and pelvis. These areas 
may receive from 200 to 300 R during the first 
course of treatment with further therapy depend- 
ing upon the rate of erythrocytic regeneration. 
The spleen should not be irradiated since it is the 
organ primarily concerned with removal of ery- 
throcytes from the circulation. Spray therapy or 
total irradiation has been advocated and consists of 
relatively small doses of x-ray from a distance of 
2 to 2.5 meters applied to the entire body. Ex- 
cellent results from the use of this technic have 
been reported.^® 

The use of radioactive phosphorus’^ is the most 
recent therapeutic procedure but is still in the 
experimental stage. This material becomes con- 
centrated in the bone marrow where it is most 
effective and has the added advantage of oral 
administration and an absence of irradiation sick- 
ness. It is not yet available in sufficient quantities 
for general use, but the preliminary reports are 
exceedingly promising. 

The best method of therapy at present is re- 
peated venesection combined with irradiation of 
the hematopoietic centers. Venesection may be 
performed as often as necessary, and subsequent 
courses of irradiation may be given when erythro- 
cytic regeneration becomes too rapid. Satisfac- 
tory and prolonged remissions may be produced 
by this method of treatmeirt. 

bibliography 

1. Osier, W. : Chronic cyanosis, with polycythemia and en- 
larged spleen; a new clinical entity. Am. J. M. Sc., cxxvi:187- 
201 (August) 1903. 

2. Osier, W. : Chronic cyanotic polycythemia with enlarged 

spleen. Brit. M. J., i:121-122 (January 16) 1904, 

3. Reznikoff, P., Foot, N. C., and Bethea, J. M. : Etiologic 
and pathologic factors in polycythemia vera. Am. J. M. Sc., 
clxxxix :753-759 (June) 1935. 

4. Haden, R. L. : Red cell mass in polycythemia in relation to 
diagnosis and treatment. Am. J. M. Sc., cxcvi :493-502 (October) 
1938. 

5. Dameshek, W., and Hanstell, H. H. : Diagnosis of poly- 
cythemia. Ann. Int. Med., xiii :1360-1387 (February) 1940. 

6. Altschule, M. D., Volk, C. C., and Henstell, H. : Cardiac 
and respiratory function at rest in patients with uncomplicated 
polycythemia vera. Am. J. M. Sc., cc:478-483 (October) 1940. 

7. Rosenthal, N., and Bassen, F. A. : Course in polycythemia. 
Arch. Int, Med., lxii:903-917 (December) 1938. 

8. Ifarrop, G. A., Jr.: Polycythemia. Medicine, vii :291-344 
(August) 1928. 

9. Minot, G. R., and Buckman, T. E. ; Erythremia (poly- 
cythemia rubra vera) ; development of anemia ; relation to leu- 
kemia ; consideration of basal metabolism, blood formation and 
destruction and fragility of red cells. Am. J. M. Sc., clxvi :469-489 
(October) 1923. 

10. Pierson, J. W., and Smith, C. D.: Treatment of polycythe- 
mia vera by roentgen irradiation of entire body. Am. J, Roent- 
genol., xliii:577-683 (April) 1940. 

11. Erf, L. A., and Lawrence, J. H. : Clinical studies with aid 
of radio-phosphorus ; absorption and distribution of radio-phos- 
phorus in blood of, its excretion by, and its therapeutic effect on, 
patients with polycythemia. Ann. Int. Med., xv:276-290 (August) 
1941. 


83 


Journal of Iowa State Medical Society 


Yol. XXXV, No. 3 

HEART DISEASE AND PREGNANCY* 

Edward W. Anderson, M.D., Des Moines 

Late in the nineteenth century James IMacken- 
zie was “summoned one night to help a young- 
woman in the pains of childbirtli.' She was a 
patient of his own, a girl whom he had visited 
during the period of her expectancy and whom 
he had then examined. The case promised to be 
easy and uneventful. 

“As he assured the girl’s mother and husband 
that all was well, during one of the great silences 
that falls after the pain has passed, a dusky hue 
overspread the girl’s face. Suddenly he started 
from his chair, his face pale and his eyes fearful. 
The girl was dead. She had died of sudden heart 
failure.’’ James Mackenzie, as he turned to 
break tbe news of her death to her husband, tasted 
tbe bitterest anguish which any doctor can ever 
experience. 

An hour later, as he asked himself whether the 
girl, before the time of delivery, had shown signs 
or symptoms which might have served as warn- 
ings, he resolved to study in women the mechanism 
and history of the symptoms usually supposed to 
indicate heart trouble. It was thus that Macken- 
zie became a heart specialist. His studies began 
after he had ransacked the literature of that day — 
to no avail. Since then, many have become inter- 
ested and there has been much work done on the 
subject of tbe heart in pregnancy. 

Pregnancy somewhat increases the blood flow 
and the work of the circulatory apparatus. It is es- 
timated that the work of the heart is about 25 per 
cent greater during pregnancy than during the 
puerperium. Studies of pregnant women in New 
England have shown that about 2 per cent of all 
cases have heart symptoms or signs. 

Through many sources the incidence of heart 
disease in the pregnant woman appears to be about 
1 per cent in the areas which manifest the great- 
est interest in the problem. The recorded death 
rate varies but is definitely declining as tbe man- 
agement of these cases improves. It has become 
nearer 2 per cent from an original figure of 8 to 
10 per cent. Tbe estimated deaths in relation to 
the total number of births average about 50 per 
100,000, an index which also is decreasing with 
time. 

The large majority of pregnant women with real 
heart disease have chronic rheumatic valvular 
defects. Congenital defects ( 1 :5,000) , luetic aor- 
titis, hypertension, subacute bacterial endocarditis 
(1 per cent) and thyrotoxicosis are relatively rare 

♦Presented before the Ninety-Third Annual Session, Iowa State 
Medical Society, Des Moines, April 20 and 21, 1944. 


with pregnancy, making np less than 10 per cent 
of cases of heart disease in pregnancy. 

Heart disease ranks among the four or five 
most important causes of maternal deaths. It ac- 
counts probably for approximately 7 per cent of 
all fatalities and claims close to 1,000 women per 
year in the United States. 

Many signs and symptoms suggestive of heart 
disease may be seen in pregnancy even when the 
heart is normal. This has necessitated the use of 
a preliminary diagnosis of “possible heart dis- 
ease.” Dyspnea, tachycardia, and edema have a 
relative value. They may be produced by preg- 
nancy, but in the presence of heart disease they 
indicate that the damaged heart is becoming em- 
barrassed. Cardiac enlargement is of diagnostic 
value only when it is definite. Murmurs are of 
real value only under certain circumstances ; a 
presystolic murmur at the apex and a diastolic 
over the aortic area are most suggestive. Systolic 
murmurs must always be considered in relation to 
other findings. Arrhythmias are of the same diag- 
nostic value in pregnancy as those apart from 
pregnancy. A history of rheumatic fever is sug- 
gestive. Heart failure should be suspected in the 
earliest signs of cardiac embarrassment because it 
is of the greatest therapeutic value to recognize it 
early. A prenatal or postpartum pulse rate over 
110 and respiration of 24 are suggestive of early 
heart failure. 

A correct estimate of the prognosis is of great 
importance, but it is as difficult as it is important. 
Twenty-seven years ago Kellogg made this state- 
ment : “We know that we do not know what any 
given heart will do in pregnancy or labor until it 
has done it. We have seen a completely decom- 
pensated cardiac survive two eclamptic convulsions 
and an accouchement force ; we have been told by 
first rate internists that this woman will stand 
delivery — and she dies on the table ; we have been 
told that this woman seen at the fourth month by 
a competent internist will go through pregnancy 
well — she is on edge from the fifth month on, gets 
acute cardiac dilatation in labor, has a severe post- 
partum hemorrhage which first saves her life and 
then threatens to kill her, has her uterus packed ; 
we are told she will die ; she lives to go moderate- 
ly septic ; she does not die ; we are told she will 
always be an invalid — she brings up a baby be- 
ginning four weeks later, and six months after- 
ward is looking after her baby, her husband and 
two brothers, teaching three classes of stammerers 
not to stammer, lives in a seven room apartment 
which is always clean, and considers a maid ser- 
vant unwarranted extravagance.” The difficulty 
in prognosis of heart disease in the pregnant 
patient is still strikingly true. 


84 

There is no pl:iyin»- safe in nlistetric cardiology, 
for no child should he needlessly sacrificed out of 
excessive consideration for the mother, and too 
great reluctance to interfere may he disastrous 
to her, sometimes without benefit to the child. 

The functional capacity of the heart is one of 
the best prognostic indices. The classification of 
heart disease based on the functional ability of 
tbe patient recommended by the American Heart 
Association is as follows : 

Class I — Patients snfifering from organic heart 
disease aide to carry on ordinary physical activity 
without discomfort. 

Class II — Patients suffering from organic heart 
disease nnable to carry on ordinary physical ac- 
tivity without discomfort. 

a. Activity slightly limited. 

b. Activity greatly limited. 

Class III — Patients suffering from organic 
heart disease showing definite symptoms of heart 
failure when at rest. 

Applying this functional classification to preg- 
nant cardiac patients, it may be stated that pa- 
tients in Classes I and Il-a have a good prognosis, 
those in Class Il-b have a gxiarded, and those in 
Class III have a poor prognosis. 

As I have stated, the death rate from heart dis- 
ease and pregnancy has fallen from 8 to 10 per 
cent to 2 to 3 per cent, which is at least three 
times as great as the present gross maternal death 
rate in the United States. 

Congestive failure is a factor in at least 70 per 
cent of the cases fatal from this complication of 
heart disease and pregnancy. A large number of 
the remainder die from pulmonary causes, includ- 
ing pulmonary edema. Occasionally, patients die 
from cardiac exhaustion or sudden collapse. The 
incidence from sepsis is also above what would 
be expected, but there is no evidence that the 
death rate from eclampsia is increased by heart 
disease. 

Congestive failure is by far the most important 
cause of death in pregnant cardiac patients, al- 
though the majorit)' of them who develop this 
complication recover compensation. Most of the 
deaths occur during pregnancy, although the inci- 
dence is highest during labor. The tendency to 
failure increases as pregnancy advances. Over- 
work and infection are important precipitating 
causes. The earlier that congestive failure oc- 
curs, the worse the prognosis. It advances faster 
in pregnant women. About 75 per cent of fatal 
cases survive delivery, but at least half of these 
patients deliver prematurely before they die. The 
death rate is low during the early months of preg- 


March, 1945 

nancy, but shows a distinct increase abont the 
seventh month. 

d'he older the cardiac ]>regnant woman, the less 
favorable the prognosis. The prognosis is ad- 
versely affected by increase in the size of the heart. 
The data on the significance of mitral stenosis on 
the prognosis is most confusing, but the general 
thought is that it is less favorable. While no 
danger seems to attach to isolated aortic lesions, 
the presence of combined mitral and aortic lesions 
adds materially to the gravity of the prognosis. 
If auricular fibrillation is a late complication of 
advanced valvular disease of the heart, it is of 
serious prognostic importance. Patients with ad- 
herent pericardium, although they usually come 
to grief during the strain of labor or soon after, 
have successfully accomplished pregnancy and 
childbirth. There is no evidence that childbear- 
ing exacerbates rheumatic infection or hastens 
any pathologic process in the heart, but it may 
accelerate the onset and development of congestive 
failure by adding to the load of the circulation. 

Heart disease per se does not favor prematurity, 
ljut congestive failure predisposes to premature 
delivery and encourages infantile mortality. 

Complications of valvular disease of the heart 
occasionally modify the regular clinical picture. 
Congestive failure may be associated with acute 
rheumatic changes in the heart, especially in the 
young. Acute endocarditis has been found in a 
high percentage of fatal cases of heart disease and 
pregnancy. Evidence is lacking that toxemia af- 
fects rheumatic heart disease and pregnancy un- 
favorably. Renal changes found in fatal cases of 
heart disease and pregnancy are difficult to dis- 
tinguish clearly from those caused by congestive 
failure, toxemia, or nephritis. There is an in- 
creasing tendency for embolism during labor and 
the first twelve hours after to occur in the pres- 
ence of auricular fibrillation, congestive failure, 
and as a complication of bacterial endocarditis. 

Pulmonary edema, a most dreaded complication 
probably due to the mechanical causes of left ven- 
tricular and auricular failure, is especially prone 
to occur during labor or tbe first twelve hours 
after and attacks mostly younger women who have 
combined mitral and aortic lesions. The death rate 
is high, about 60 per cent. \^alvular disease of 
the heart increases the incidence of pneumonia 
in pregnancy, both as a complication and as a cause 
of death. Tuberculosis, or anemia, unless very 
severe, rarely affects the prognosis unfavorably. 
Obesity obviously handicaps valvular disease at 
all times and especially when the diseased heart 
must carry the extra load of pregnancy. No evi- 
dence has been obtained that valvular disease of 


Journal of Iowa State Medical Society 


\’ 0 L. XXXV, No. 3 


Journal of Iowa State Medical Society 


85 


the heart is associated with an increase in the 
death rate from puerperal sepsis. 

In the management of the pregnant cardiac pa- 
tient, we shall first consider the advice given con- 
cerning pregnancy in the cardiac individual. Ad- 
vice as to marriage and pregnancy should be given 
when heart disease is first diagnosed, and as to 
repetition of pregnancy, during the puerperium. 
This advice has become more lenient than former- 
1}' for several reasons. Improved prenatal care 
has greatly reduced the death rate from heart dis- 
ease and pregnancy. During compensation strict 
and frequent supervision is indicated. Bed rest 
should be advised only insofar as it improves car- 
diac tone. Decompensation should be treated early 
and thoroughly, and not until treatment has failed 
should pregnancy be interrupted. The treatment 
of interruption of pregnancy has gone through a 
wide cycle during the past hundred years. First 
strongly opposed, with the rise of antiseptic sur- 
gery it became too freely used. It should now 
rarely be performed and only in those cases in 
which the patient does not respond to the treat- 
ment of heart failure, and when possible it should 
be deferred until the thirty-sixth week, when the 
chances of the infant are so much better. Social 
factors, while important, should not be confused 
with the medical aspects. While acute pulmonary 
edema is a contraindication, the other complica- 
tions, mitral stenosis being no exception, are not 
absolute indications for the interruption of preg- 
nancy. 

1'here is no convincing evidence that the dura- 
tion of labor is affected by the presence of heart 
disease. As long as there is no evidence of cardiac 
embarrassment, there is no reason to modify rou- 
tine procedures of labor, except that the patient 
should be supervised with more than usual care. 
The semirecumhent position is indicated in case 
of dyspnea, hut not routinely. Cardiac symptoms 
arising during labor require the prompt use of 
digitalis. If the symptoms progress, forceps de- 
livery is indicated late in labor, cesarean section 
early. Since 1900, the use of cesarean section 
has been greatly developed, but the trend in Amer- 
ica is toward a conservative attitude. If per- 
formed liefore labor is far advanced, it is the 
safest way of relieving an embarrassed heart of 
the strain of lalior. The chief danger to the 
mother is sepsis, to the baby asphyxia. Cesarean 
in mortua has saved many liabies of cardiac moth- 
ers if performed within twenty minutes of the 
mother’s death, and may be successful as early as 
the twenty-fourth week of pregnancy. Pulmonary 
edema arising during pregnancy should he treated 
with morphine, venesection, and digitalis. Steril- 
ization is indicated in heart disease when a woman 


has had as many children as she can physically 
manage. Lactation should be avoided only when 
cardiac failure threatens and all means must be 
employed to conserve cardiac strength. 

SUMMARY 

1. The incidence of heart disease in pregnancy 
is about 1 per cent. 

2. Chronic rheumatic valvular defects occur in 
the greatest majority of cardiac pregnant women. 

3. Congestive failure is the most important 
cause of death in the pregnant cardiac patient. 

4. The prognosis is most difficult, but the func- 
tional capacity of the heart is the best prognostic 
index. 

5. Treatment of cardiac failure should lie insti- 
tuted early and thoroughly. 


ANNUAL CONVENTION OF AMERICAN PSY- 
CHIATRIC ASSOCIATION CANCELLED 
The American Psychiatric Association, the oldest 
medical society in America, has announced the can- 
cellation of its 101st annual meeting, which was to 
have been held in Chicago in May of this year. It 
was the feeling of the Association that it would he 
the duty of the membership to fall in line with the 
request of the United States Government to cancel 
conventions in the spirit of the war cooperation. 

There will be a meeting of the Councillors of the 
American Psychiatric Association on February 26 
and 27 to devise the means of taking care of urgent 
business of the Association arising out of the can- 
cellation of the annual meeting. 


CORRECTION 

The Journal is pleased to publish the following 
letter received from Dr. Walter L. Bierring relative 
to a statement carried in the December issue of the 
Journal on page 507: 

“May I ask the correction of a statement that was 
taken from my informal talk at the House of Dele- 
gates luncheon November 1, 1944? 

“The statement as printed is ‘Dr. Mountin was 
assigned to a station in India for three years.’ This 
was based on hearsay and was not correct, as I have 
since learned that the negotiations to send Doctor 
Mountin to India were instituted at least three 
months prior to the American Public Health Associa- 
tion meeting, and his detail was made in response to 
the request of the British Government in behalf of 
the Indian Medical Service which desired to consult 
with Doctor Mountin concerning public health ad- 
ministration in the United States. The detail was 
for three months, not for three years, and Dr. Moun- 
tin was returned to the United States and is now en- 
gaged in his usual duties as Chief of the Division 
of States Relations, U. S. Public Health Service, 
Washington, D. C.’’ 


86 


Journal of Iowa Statf. Medical Society 


March, 1945 



SALMONELLOSIS OUTBREAK TRACED 
TO IOWA 

Members of the crew of a merchant ship which 
started from Norfolk, Virginia, became ill with 
gastro-enteritis in January, 1945, shohly before 
arrival at New Orleans, Louisiana. 

Investigation of the epidemic was made by 
James Watt, M.D., Surgeon, U. S. Public Health 
Service, stationed at New Orleans. Laboratory 
examination of rectal swabs from patients and 
others who had been exposed led to isolation of 
a Salmonella organism, a strain which proved to 
be Salmonella montevideo. Investigation of 
water, milk, and food supplies revealed that may- 
onnaise dressing was the probable vehicle of trans- 
mission, and that eggs used in the mayonnaise 
were the probable source of contamination. 

Bacteriologic study was made of the yolks of 
eggs, several crates of which remained from the 
supply of provisions taken on at Norfolk. Eleven 
of fourteen flasks containing pooled yolks of a 
crate of eggs were found to harbor S. montevideo, 
the same Salmonella strain which was found to 
have caused the illness. (The isolation of Sal- 
monella from the egg yolk is traceable to infection 
in the ovary and oviduct of the hen, infection 
being transmitted congenitally to the eggs.) 

Dr. Watt learned that the eggs which were 
taken aboard at Norfolk had been processed and 
kept under constant refrigeration aboard ship. 
The eggs were purchased from a produce dealer 
in Creston, Union County, Iowa. Dr. Watt vis- 
ited the Iowa State Department of Health, Janu- 
ary 27, 1945 ; he then went to Creston where the 
following two weeks were spent in search of the 
particular strain of Salmonella organism incrimi- 
nated in the New Orleans outbreak. 

A mobile trailer-laboratory equipped for bac- 
teriologic work was made available through the 
district office of the U. S. Public Health Service 
in Kansas City, Missouri. Petri plates and other 
supplies as needed were furnished by I. H. Ports, 
M.D., Director of the Iowa State Hygienic Lab- 
oratory in Iowa City. Dr. Watt was ably as- 


sisted by Captain Cecil B. Chambers, bacteriolo- 
gist, and two laboratory helpers. 

During the stay in Creston visits were made to 
approximately 150 producer-farms from which 
eggs are delivered to the processing plant in 
Creston. Inquiry in the farm homes elicited no 
unusual history of enteritis affecting human be- 
ings or of infection in poultry flocks. 

Bacteriologic work was confined to the study 
of cloacal cultures taken from individual hens or 
from fresh droppings in poultry houses on dif- 
ferent farms, and to culture of the yolks of eighty 
dozen eggs, these eggs having been discarded as 
the result of candling and because of their content 
of blood. 

The staff members of the U. S. Public Health 
Service succeeded in isolating several strains of 
Salmonella from the material cultured : the monte- 
video strain had not been identified with certainty 
at the end of the two weeks’ survey. 

The bacteriologic study of eggs from the Cres- 
ton, Leon, and Osceola areas is being continued in 
the Public Health Service Laboratory in New 
Orleans. Arrangement has been made in cooper- 
ation with produce dealers whereby eggs from 
various farms will be shipped from time to time 
to the Louisiana laboratory. 


BRUCELLA AGGLUTINATION SURVEY AMONG 
VETERINARIANS 

On January 23-24, 1945, in cooperation with 
officers and members of the Iowa Veterinary Med- 
ical Association, and on the occasion of the an- 
nual meeting of that organization, blood speci- 
mens were secured from 133 veterinarians who 
served as volunteers. The specimens were for- 
warded to the State Hygienic Laboratory in Iowa 
City, where agglutination tests were carried out 
on the blood serums. 

Of 132 serum specimens examined (one speci- 
men had serum in amount insufficient for testing) , 
three showed positive agglutination of brucella 
antigen, two in a dilution of 1 :40 and one, 1 :80. 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


87 


These titers, although not strongly positive, are 
considered definite evidence of exposure to bru- 
cella. 

The incidence of positive agglutination in sig- 
nificant dilution in the recent survey was 2 per 
cent. In a similar study of the blood serum of 
Iowa veterinarians made fifteen years ago, in 
January 1930, four of 120 specimens showed 
reaction in a dilution of 1 ;40, a significantly posi- 
tive agglutination incidence of 3 per cent. 


SCARLET FEVER— 1944 


Reported cases of scarlet fever in Iowa totaled 
4,530 in 1940, an annual morbidity rate of 178.5 
per 100,000. In the nation as a whole, reported 
cases for 1944 numbered 190,306, an annual mor- 
bidity rate of 144.5 per 100,000 population. 


In the accompanying line diagram, the solid line 
shows cases of scarlet fever as reported to the 
State Department of Health by months in 1944. 
The dotted line indicates cases which were ex- 
pected to be reported month to month during 1944, 
being the average of scarlet fever reports for the 
past nine years, 1935-1943. As noted in the graph, 
scarlet fever was unduly prevalent throughout Feb- 
ruary, March, April, May, June, and July of last 
year. On the other hand, case totals for the re- 



mjjasofd 


scarlet fever in IOWA— 1944 
Reports by months compared 
with the 9-year average 1836-1948 


maining months, August through December, were 
below the expected average. 

In January of 1945, reported cases of this dis- 
ease were 389 (expected number 395). Reports 
numbered 134 for the first two weeks of February, 
436 being the expected total for the entire month. 



J FUAUJJAS.OND 
MONTHS 


TYPHOID FEVER IN IOWA— 1944 
Comparison of month-by-month reports 
with the monthly average for the period 1936-1943 

TYPHOID FEVER— 1944 

With the exception of September, typhoid fever 
showed below average prevalence for the other 
eleven months of 1944. Fifty cases were reported 
for the entire year, the expected total being 96, the 
annual average for the nine-year period 1935- 
1943. 

The accompanying line graph records the cases 
of typhoid fever as notified during 1944 (solid 
line), compared with the expected number (dotted 
line), the latter based on the experience of the 
past nine years. 

The sharp rise in prevalence in September of 
last year was due to the outbreak of typhoid fever 
which occurred at Brayton (Audubon County) 
and vicinity. Out of the total of 20 cases notified 
in September, 18 of the patients were victims of 
the epidemic, of whom 15 resided in Audubon 
County, two in Cass, and one in Guthrie County. 


8S 


Journal ok Iowa State Medical Society 


March, 1945 



ISSUED MONTHLY 


Leb Foeeest Hill, Editor Des Moines 

Dennis H. Kellt, Associate Editor Des Moines 

PUBLICATION COMMITTEE 

Leb Forrest Hill, Editor Des Moines 

Dennis H. Kelly, Associate Editor Des Moines 

Robert L, Parker, Secretary Des Moines 

Oliver J, Fat, Trustee Des Moines 

John I, Marker, Trustee Davenport 

Walter A, Sternberg, Trustee Mount Pleasant 


SUBSCRIPTION $3.00 PER YEAR 

Address all communications to the Editor of the Journal, 
SOS Bankers Trust Building, Des Moines Q 

OrFioB or PiTBLioATiON, Dks Moinbs 9, Iowa 

Vol. XXXV MARCH, 1945 No. 3 


NURSE RECRUITMENT FOR MILITARY 
SERVICES 

Something seems to have gone decidedly wrong 
in the procurement of a sufficient numher of grad- 
uate nurses to meet the needs of our armed forces. 
So acute has the shortage become that President 
Roosevelt on January 6 requested Congress to 
enact a law permitting the immediate drafting of 
nurses so that quotas coitld be met. 

According to the Fact Sheet prepared by the 
National Nursing Council for War Service in 
cooperation with a numher of other groups, the 
emergency needs of the Army are for 18,000 
nurses in addition to the 42,000 already in service, 
2,335 for the Navy in addition to a present 
strength of 9,165, and for 3,000 additional nurses 
to the 4,150 on duty with the Veterans Administra- 
tion. This adds up to a total of 23,335 nurses who 
are urgently needed at once, or will be needed 
within the immediate months ahead, to- care for our 
sick and wounded fighting men at home and 
abroad. The statement is made that Army hos- 
pitals here are operating with as few as one nurse 
to twenty-six beds while the authorized ratio is one 
nurse to fifteen beds in the United States and one 
to twelve overseas. 

This is a serious situation indeed and one of im- 
mediate interest and concern to all physicians,- hos- 
pitals, and industrial institutions since these groups 
are largely involved in the employment of nurses. 
No argument is needed to sell any of us upon the 
fact that our sick and wounded fighting men have 
first call upon the total available supply of trained 
nurses. That their needs must be met is taken for 
granted, and we feel sure that there will be earnest 
and prompt cooperation from all sources to see to 
it that the existing shortage is promptly eliminated. 


Rut what interests us is the reason why any 
shortage, or perhaps such an urgent shortage as 
would make it necessary to send eleven hospital 
units overseas without any nurses at all, has been 
allowed to develop. Publicity of the last few 
weeks has tended to create the impression in the 
minds of the general public that the fault lies with 
the nurses for not volunteering — in other words 
that they as a group are unpatriotic. Our sense 
of fair play impels us to arise to the defense of 
our sister profession against such an impression. 
Can it not be that equal or even greater culpability 
rests elsewhere? And if so, ought it not to be 
frankly admitted by those officials in high places 
to whom has been assigned tbe responsibility of 
nurse recruitment? For instance there is the 
statement of Katherine J. Densford, president of 
the American Nurses Association, made before 
federal officials at hearings in Washington and pub- 
lished in the Des Moines Register to the effect that, 
“The shortage of military nurses is at least partly 
the fault of the armed services themselves, because 
they set quotas, raised them, lowered them, and 
raised them again until the nursing profession 
didn’t know how many nurses were required.” 
And further, “There never has been a full scale 
federal effort to recruit nurses. Most of the job 
to date has been done by the nurses themselves 
voluntarily and without pay. The government’s 
contribution to the program was to provide for 
about sixty-five clerical workers throughout the 
whole country. The War Manpower Commission 
and the Red Cross, cooperating as they have in the 
past and aided l>y enough federal money and au- 
thority to put on a recruiting drive as intensive as 
those for the WACs and WAVES could fill 
military nursing needs without a draft.” 

What about the Cadet Nursing Corps? It was 
our impression that this was a well conceived and 
efficient plan for filling quotas as the need arose. 
According to the Fact Sheet there were 24,821 
Senior Cadets in 1944-45. The total number 
of Senior Cadet Nurses applying for federal 
service from April through December 1944 was 
10.168. The total referred to federal service in 
this same period was 8,923 and the total accepted 
by federal service was 1,931. No reason for the 
large numlier of rejections is given. It seems 
permissible to ask why, if the government is 
financing the nursing education of these girls, 
they were not given physical fitness examinations 
before being accepted and why they were not en- 
rolled for military duty exclusively following 
graduation and successful passing of State Board 
examinations? Had some such arrangement as 
this been set up would it not have obviated the 
necessity of subjecting the nursing profession to 


VoL. XXXV, No. 3 


89 


Journal of Iowa State Medical Society 


the humility of being the only group of women in 
the nation singled out for drafting? 

Again it seems only reasonable to inquire into 
the status of the 8,169 male nurses and the 9,000 
colored nurses, both groups of whom have had the 
same basic training as the white female nurses. 
Male nurses by law are not commissioned in the 
Army Nurse Corps, although between 2,000 and 
2,500 of them are serving in the armed forces in 
some capacity or other but not as commissioned 
officers in the field of nursing. Only 308 of the 
total 9,000 negro nurses are enrolled in the 
Army Nurse Corps. Obviously eleven hospital 
units would not have had to be sent abroad without 
nurses if these sources had been utilized. 

Naturally those of us who live in Iowa are in- 
terested in what our home state has done in the 
way of nurse recruitment. The following infor- 
mation was provided the Journal by a reliable 
source. In 1943 the total quota assigned Iowa was 
353. Enrollment was 504. From January 1, 
1944, through June 30 the c|uota was 92, and the 
number assigned was 153. From July 1 through 
January 31, 1944, the quota was 153, and 94 nurses 
were assigned. Thus a deficit occurred in the 
latter half of 1944, hut the total quota for the year 
was 245, and the total assignment was 247. For 
the first six months of 1945 a total of 292 nurses 
will be required. So far only 30 of this number 
have been obtained. From January 1, 1943, to 
January 1, 1945, the number of successful candi- 
dates in the Iowa State Board examinations was 
1,196. In the same period of time 781 registered 
nurses entered military service from this state. 

Regarding recruitment of nurses in other parts 
of the country we are informed that so far the 
greater number of nurses in military service are 
being enlisted from the North Central, Central and 
Southern states. These states are meeting their 
quotas and making up for the Eastern and Western 
states in which quotas have not been reached. 

Presumably by the time these comments are 
published the matter of selective service legislation 
for drafting of nurses will have been settled by 
Congress. It is the Journal’’s hope that it will 
not be necessary to resort to such legislation unless 
the nurses are included in a general National Serv- 
ice Act. We have every confidence in the patrio- 
tism of ffie nursing profession, and we believe that 
military officials and the officials of the Procure- 
ment and Assignment Service for Nurses should 
assume their full share of responsibility for the 
present shortage of nurses in the armed forces. 
If the recruitment program as set up by the Army 
and Navy, the War Manpower Commission, and 
the American Red Cross has failed and a selective 
service law becomes necessary to meet the present 
critical emergency, then a full public explanation 


of the reasons for the failure of the volunteer 
method is only just and right. Our criticisms 
have only to do with this phase of the problem. 
We would again make it clear that the needs of 
the men who have been wounded in battle or who 
have become ill while on military duty are of first 
concern to every one of us. We are in complete 
accord with any method which becomes necessary 
to ensure adequate nursing service for these boys, 
but let’s have the facts about why a nursing short- 
age for them was ever allowed to develop. 


STATUS OF THE MEDICAL SERVICE PLAN 

No formal report has been made on the 'status of 
the medical service plan since publication of the 
minutes of the special meeting of the Plouse of 
Delegates in the Decemlier Journal. Work has 
gone forward constantly since that time, however. 

The Legislative Committee prepared an en- 
abling act to present to the Legislature which would 
make possible the formation of a non-profit cor- 
poration for medical care. This was passed by 
both the Senate and House of Representatives 
without a dissenting vote, an indication of the 
favor with which it was received by the legislators. 
It also received much favorable publicity in news- 
papers over the state. Governor Blue signed the 
bill February 15, and now all that remains is 
publication, after which it will become law. 

The Executive Council held two meetings to 
appoint a temporary board of directors to help 
with writing the contract, establishing a fee 
schedule, and obtaining the articles of incorpora- 
tion. This board has also met and appointed 
various committees to carry on the work. 

The contract committee has had several meet- 
ings to discuss the best type of contract, and is now 
ready to submit its final draft to the executive 
committee and the board. The fee schedule com- 
mittee has also met and established a fee schedule 
in accord with the contract and the proposed rate 
structure. This also is ready for submission to 
the executive committee and the board. 

It is expected that the executive committee will 
meet in the very near future and pass upon these 
matters, after which the board will meet to give 
its approval or disapproval of the recommenda- 
tions. The executive committee has also as its 
duty the hiring of personnel for the new company, 
renting office space, and procuring equipment. All 
of this is receiving the attention of those who are 
working on the plan. 

All in all, those directly responsible for the plan 
have worked steadily upon it since the House of 
Delegates meeting November 1. Three lay mem- 
bers of the board have contributed largely of 
their time and thought in writing the new contract 


90 


Journal of Iowa State Medical Society 


March, 1945 


and deserve tlie sincere thanks of the medical pro- 
fession for the study they have given it. When the 
contract is hnally written and the plan is ready for 
presentation, it will represent countless hours of 
thought and effort to make it the best ix)ssihle plan 
for the subscribers and the medical profession 
which is offering it. Soon it wilt be time for the 
rank and file of our state membership to do its 
part in cooperating with the plan to make it the 
success which our committees have given their 
best efforts to ensure. The Journal trusts we will 
not disappoint them. 


PREVENTION OF WHOOPING COUGH IN 
EARLY MONTHS OF INFANCY 

The development of an effective prophylactic 
agent against whooping cough marked^ a definite 
advance in the control of this disease. However, 
a problem still remained in that it is recommended 
that the vaccine be administered in the second six 
months of life, whereas the chief mortality from 
the disease occurs in the first half year of life. In 
an effort to find a solution to this phase of the 
problem, Sako et al. report in the February 17 is- 
sue of The Journal of the American Medical 
Association their experiences with alum precipi- 
tated pertussis vaccine given to infants three 
months of age or younger. The authors state that 
their primary purpose in the study was not to 
evaluate the prophylactic value of the vaccine but 
rather to study the reaction of infants three 
months of age or younger to parenteral injection 
of the alum precipitated vaccine and the antibody 
response as measured by agglutination tests of 
these young infants so inoculated. Previous studies 
had indicated that good antibody response to per- 
tussis vaccine was not likely to result until after 
the age of seven months. The authors inoculated a 
total of 3,793 infants with alum precipitated 
Hemophilus pertussis vaccine in monthly dosages 
of 0.2, 0.3, and 0.5 cubic centimeter. The vaccine 
contained forty billion bacilli per cubic centimeter. 
Observations were made on reactions to these inoc- 
ulations and to the subsequent development of ag- 
glutinins for Hemophilus pertussis. Also, some 
attempt vras made to observe the incidence of 
whooping cough and the mortality in a portion of 
this group (1,834), as compared with 1,965 non- 
immunized infants, for a period of twelve to 
twenty-seven months. Concerning the reaction, 
the authors state that of a total of 6,600 inocu- 
lations in the first gi'oup 568 infants, or 8.6 per 
cent, showed appreciable reactions, but only 48 
of these reactions exceeded a moderate degree of 
severity. Forty-nine patients reacted to two in- 
oculations and six patients reacted with each in- 
oculation. A total of 38 abscesses occurred in 


group A ; all of these subsided without special 
treatment. The authors conclude that young in- 
fants tolerated the inoculations extremely well, 
and from their studies they feel that there is no 
contraindication on the basis of reactions to the 
giving of alum precipitated pertussis vaccine in 
the dosage recommended to infants under three 
months of age. 

Agglutination tests showed that 78.2 per cent 
of the 1,834 infants in group A gave moderate 
or strongly positive agglutination tests two to four 
months after completion of immunization, and 
that most of these infants maintained their posi- 
tive agglutination titers for at least two years. In 
this group of infants who were followed for twelve 
to twenty-seven months some thirty developed 
whooping cough with no deaths. In the control 
group of 1,965 nonimmunized infants 127 con- 
tracted whooping cough and there were thirteen 
deaths and thirteen who contracted pneumonia 
which was treated successfully. Thus there is 
definite evidence that pertussis prophylaxis using 
alum precipitated toxoid in monthly dosage of 
0.2, 0.3, and 0.5 cubic centimeter is a practical 
procedure and that the mortality from the disease 
may be distinctly lessened. In discussing the 
paper, Sauer, originator of the present type of per- 
tussis vaccine, indicated that since nothing is 
known as yet on the duration of immunology con- 
ferred so early in life it might be advisable to 
revaccinate later, perhaps at nine months of age, 
in order to secure a more lasting type of im- 
munity. 


IOWA SOCIETY FOR CRIPPLED CHILDREN 
AND THE DISABLED CARRIES ON 

For thousands in America chained to ineffective 
bodies, their lives may mean heartbreak to them- 
selves and to their associates. The number of the 
disabled will swell as men, maimed and crushed 
by war, return to America. 

The Iowa Society for Crippled Children and 
the Disabled is dedicated to relieving, as far as 
possible, the tragedies of handicapped people. Its 
policies embrace provision of material assistance 
and service to the physically handicapped people 
from birth through maturity, regardless of the 
cause of the handicap. It cooperates with profes- 
sional, lay, and governmental agencies* without 
duplicating their programs, and is a clearing house 
for general information for the crippled available 
within the state. 

The society is demonstrating a service that in- 
cludes prevention, case-finding, treatment, special 
education, recreation, emotional adjustment, voca- 
tional counseling, and employment for the home- 
bound. It is a gigantic task and one that con- 


\' 0 L. XXXV, No. 3 


Journal of Iowa State Medical Society 


91 


stantly increases as new people learn of the seiAoce 
of the society. 

The Iowa society is working hard to assure rec- 
ognition of the handicapped child in the proposed 
revision of the Iowa School Code. It drafted a 
bill for presentation in 1943 which was the basis 
for the improved chapter included by the School 
Code Commission in its 1944 report. It is now 
working for the adoption of that bill which would 
provide special education for all handicapped chil- 
dren, employ qualified instructors for special in- 
struction in day classes, schools, homes, hospitals, 
or other places of education. It urges special 
equipment and appliances for the handicapped 
child, special courses of study to meet his needs, 
and arranges with any school district a means for 
his transportation to the classroom. 

It is imjx)ssible to enumerate the many varied 
services of the Iowa Society for Crippled Children 
and the Disabled. The Spastic Club of Iowa, with 
a mailing list of more than two hundred, received 
meeting summaries sent to all its members. A 
large loan library on cerebral palsy is also lieing 
used by the club members. 

Fifty-one children of Iowa attended the so- 
ciety’s special camp last year, a wonderful treat 
for children who have been forced to “be differ- 
ent’’ because of physical handicaps. 

Planned home employment has released unde- 
veloped talents and provided confidence to many a 
shattered cripple who too frequently has had lit- 
tle earning experience. 

The society has carried on its program chiefly 
by sale of the Easter seals. The inci'eased sale 
each year is an encouraging indication that public 
sentiment is awakening to the helpfulness of this 
program. It is only as donations reach the so- 
ciety in response to the campaign letter that the 
program can function and expand. 


RED CROSS PROVIDES MOVIES 
FOR HOSPITALIZED 

Although not widely known, one of the largest 
theatrical undertakings in the world is a chain of 
motion picture theaters operated by the American 
Red Cross in the Red Cross recreation houses at 
196 Army hospitals throughout the United States. 
In addition to the programs at the recreation 
houses there are 407 hospitals where motion pic- 
tures are exhibited in the hospital wards on 16 
mm. portable sound projection equipment. Last 
year audiences at these movie shows aggregated 
more than 10,000,000 men. 

This department of the American Red Cross, 
known as the Hospital Motion Picture Service, 
was established in the fall of 1941 in order that 
soldiers in Army hospitals cut ofif from the great 


G. I. pastime of movie-going, might be able to keep 
up with the latest in motion picture entertainment. 

Through the cooperation of the motion picture 
industry, the Red Cross is able to show the boys 
in the hospitals the latest movies, sometimes even 
before the pictures are exhibited in commercial 
theatres. No admission fee is charged, and only 



soldier patients and their attendants are admitted 
as audiences to these shows. 

The Hospital Motion Picture Service is operated 
by a small group of men and women trained in 
the various aspects of this field and headed by 
Edward Doyle. In three short years they have 
whipped together an organization which plays to 
a total yearly audience of millions. They have 
overcome many obstacles in this era of wartime 
shortages — chief of which has been procurement 
of equipment. In spite of this, 167 theatres have 
been equipped with standard 35 mm. sound equip- 
ment, 29 with 16 mm. dual arc sound equip- 
ment, and 407 with 16 mm. portable sound units. 

This Red Cross motion picture program, which 
started out as a purely recreational activity, has 
developed into one of the finest morale boosters in 
the Army. Many Army doctors praise its thera- 
peutic value in its effect on men whose nerves 
have been frayed by war. The soldiers simply say, 
“It’s swell of the Red Cross to bring movies to us.” 

This and other Red Cross services are made 
possible by the generous contributions of millions 
of Americans. The Red Cross is dependent en- 
tirely upon voluntary gifts to meet its many obli- 
gations, on the home front as well as on the battle 
front. 

The 1945 Red Cross War Eund is being raised 
this month. Let’s all give to the utmost of our 
ability to keep the Red Cross at the side of our 
fighting men. 


92 


Journal of Iowa State Medical Society 


March, 1945 


A PROPOSAL OF MARRIAGE 

\hNCENT Starzinger, LL.B., Des Moines 


What I want to say to you tonight, in brief, 
is that the doctors and lawyers should unite in a 
special effort to help win the war. No, I do not 
mean the war in Europe and Asia, however im- 
portant and vital that war may be ; what 1 have 
in mind is the war of ideas which is back of the 
present military conflict. 

Reduced to its most simple description, it is 
the war on individual freedom. Unfortunately, 
it is being waged with increasing effect , by more 
and more people. Most of those who espouse this 
cause are undoubtedly well-intentioned. They 
have suffered disappointments or have observed 
imperfections and inequities which they desire to 
remedy. As so frequently happens, the most 
obvious and attractive remed}" is a well promoted 
cure-all. The world constantly strives for a more 
easy way of life, not realizing that this is usually 
the road to atrophy and death. There are always 
leaders with ambition and ability who are not sat- 
isfied to build upon the sound foundations of the 
past, but have a burning desire to erect new monu- 
ments to their own glory. The present world 
catastrophe is due more than we realize to the 
blind following of leaders. 

There is a strong tendency toward collectivism. 
In some respects this is highly desirable. There 
must be law and order by organized effort to 
insure individual freedom and to permit the 
highest development of the individual. Monopo- 
lies must be curbed or controlled, whether they be 
monopolies of business, labor, government, or 
majorities. It is also true that the state may do 
many things that would be difficult, if not im- 
possible, for individuals to do, as, for example, the 
construction and maintenance of highways, parks, 
schools, libraries, and hospitals. Furthermore, 
there is no question but that society should take 
care of the indigent and disabled who are without 
means of support. It may even be sound policy 
for the state to assume the responsibility of pro- ' 
viding minimum standards of subsistence. But 
this may all be done without destroying the 
doctrine of individual initiative and private enter- 
prise. 

The danger, of course, is that the trend toward 
collective action may be gradually and unob-' 
trusively carried to the point where the individual 
has been swallowed up by the state, and the state 
is running everything, including the lives and the 
thinking of individuals. If that happens, we have 
lost our independence; we have lost our freedom. 

♦Presented before the Polk County Medical Society at its 
Annual Meeting January 17, 1945. 


We have become slaves of the party in power. 
This danger is tremendously increased by the 
industrialization of society, by the mammoth or- 
ganization of business and labor, by the amazing 
integration of the world as a result of new inven- 
tions and the development of rapid means of com- 
munication and transportation, by economic de- 
pressions and by war. It will undoubtedly be ac- 
centuated by postwar conditions. 

We are in danger of entering a push-button 
age in government. It may seem all right so long 
as the machinery functions and so long as the 
buttonpusher is a wise and just individual. But 
if the machinery becomes out of order or if some 
incompetent, some false prophet, some demagogue, 
or some lunatic gets his finger on the button, and 
we know that those things are bound to happen, 
then not only the individuals suffer, but the whole 
of society is wrecked. 

A good illustration of what I am talking about 
is the Wagner-Murray-Dingell bill. When your 
president first asked me to speak at this meeting, 
I thought I would talk on socialized medicine, and 
I did a little special reading on that subject. How- 
ever, it finally dawned upon me that you already 
knew more about that than I could hope to learn 
in the time I had for preparation, so I gave it up. 
Nevertheless, I am glad that I took the time to 
inform myself more fully on the issue. I had no 
conception of the far-reaching and detailed scope 
of the measure. It certainly abolished completely 
the i^ractice of medicine as an independent profes- 
sion. The doctors are to be congratulated upon 
checking this movement, and I am happpy to be 
able to say that the American Bar Association 
helped. 

The fundamental issue is whether individuals 
exist for organized society, or whether society 
is organized for the individuals. Is the govern- 
ment to be the master or the servant of the people ? 
Should the individual have any rights that are 
good against all comers, including the chief execu- 
tive officer, the legislative bodies, and even a 
majority of the people? Should the people be 
governed by laws, based upon experience and 
reason, applicable to all in similar circumstances, 
formulated objectively without regard for the 
interest of any person or group, predictable by 
all and framed to foster the maximum sphere of 
individual freedom of expression, choice, initia- 
tive, enterprise, and development, or should the 
people be directed by some central authority 
toward planned ends? Shall the future be de- 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


93 


termined by the countless decisions of individuals 
in a free economy governed by the rule of law, 
or shall it he planned by some centralized author- 
ity ? 

The correct decision on this issue requires the 
wisdom of the ages. It is easy to be led astray. 
The trend toward collectivism has led to socialism, 
communism, fascism and Naziism. This is the 
plain lesson of recent histoiy. For half a century, 
the European intellectuals have been preaching 
the doctrine of absolutism in government, central 
planning, totalitarianism. And while we wage 
a global war against the direct results of such 
teachings, pouring out our precious treasures of 
resources, productive capacity and individual lives, 
we find British and American intellectuals em- 
bracing and teaching the same ideas. 

I am abidingly convinced that a good society, 
a good government, economic prosperity and 
morality depend primarily upon the protection and 
development of the individual, the family unit, the 
local community, and the local state, ahead of the 
nation and the world. 

3'he great contribution of nineteenth century 
liberalism was its appreciation of the worth and 
dignity of the individual. It recognized that the 
individual, not organized society or the state, was 
the basis of creation, variation, development, enter- 
prise, freedom, character, morality and religion. 
It had the deep insight to realize that whenever 
a child is born, a new universe is created, and 
that child is the center of that new universe, and 
that new universe may be pretty much what that 
child makes it. It also had the practical sense to 
see that the crystallized customs and laws distilled 
from the infinite experiences and decisions of 
individuals in a free society were superior in the 
long run to any decrees or directives that might 
be issued by any centralized povver. 

When Patrick Henry said, “Give me liberty or 
give me death,” he was not indulging in rhetorical 
flourish, but was announcing a vital election be- 
tween two mutually exclusive basic conceptions 
of life. 

Our republic was founded in this spirit of 
nineteenth century liberalism. Its founders were 
students of political and economic history. They 
were intellectual giants, who had tasted the bitter 
experience of centralized arbitrary authority. For 
two hundred years, the colonists had been gov- 
erned by absolute authority in England. Parlia- 
ment could make laws for them and tax them. 
The Privy Council at Westminster, either directly 
or through its boards, governed them, and exer- 
cised executive, legislative and judicial power 
over them. Governors were appointed by the 
Crown and controlled by the Privy Council. It is 


true that the colonies had their provincial legis- 
latures, but their legislative acts were subject to 
veto or review by the Privy Council, and the 
Privy Council was the final court of appeal. The 
powers centered in this body were often exercised 
arbitrarily. Pennsylvania was kept from having a 
system of courts for a period of twenty years. The 
board of trade and plantations prevented the 
.establishment and fostering of industries in the 
colonies. Doctrines of primogeniture and in- 
heritance were imposed, which were repugnant to 
the colonists. Thus, the vital necessity of consti- 
tutional government to protect individual freedom 
and local self-government, and to prevent the 
centralization of arbitrary governmental power 
anywhere, became quite clear. Today, after a 
lapse of a little more than one hundred and fifty 
years, it is easy to forget this background. 

The men who set up our form of government 
undertook to protect and foster the rights and 
opportunity of the individual, even as against the 
government or the governmental officials or a 
majority of the people. They did this by adopting 
a written constitution embodying the fundamental 
law of the land. They put into the Constitution 
the Bill of Rights, guaranteeing certain funda- 
mental rights to the individual. They separated 
the powers of government into the executive, 
legislative and judicial branches. They provided 
for a system of checks and balances to insure 
sober and deliberate action. They established an 
independent judiciary to declare and enforce ob- 
jectively the rules of law. They put into effect the 
principle of federalism, whereby only specific 
limited powers were granted to the federal gov- 
ernment, and all other powers were reserved by 
the local states. 

I have no doubt that if we succeed in our effort 
to establish a world organization for the purpose 
of insuring peace and economic prosperity in the 
world, the principles adopted by our founding- 
fathers will point the way. 

Under this system, we have enjoyed a growth, 
a development, a productive capacity, and a 
standard of living unmatched anywhere, at any 
time, in the history of the world. The contribu- 
tion that this nation has made in the present 
world conflict in resources, in productive capacity, 
in the preparation and mobilization of armed 
forces, and in heroic action, is truly a modern 
miracle. It furnishes the most eloquent testimony 
of the power, strength and character of a free 
people. 

However, for more than a quarter of a century, 
our system of government has been questioned 
and attacked with increasing effectiveness in the 
interests of collectivism and absolutism. The 


94 


Journal of Towa State Medical Society 


March, 1945 


power of the executive has lieen enormously in- 
creased. The vitally important tradition limiting 
the presidential tenure to two terms has been 
disregarded. The principle of the separation of 
the powers of government has been undermined. 
Countless boards, commissions, and bureaus have 
been established. They exercise executive, legis- 
lative, and judicial powers, without adequate 
check upon their decisions by court appeal. It is 
now a common experience to witness such bodies 
acting as complainant, prosecutor, court and jury, 
in proceedings of an informal character, without 
the usual safeguards of judicial procedure. Ex- 
ecutive decrees, orders and directives have been 
issued in such great numbers and on such a variety 
of subjects that even a good lawyer is frequently 
not only unacquainted with the rules^ but does 
not know where to find them. Indeed, even the 
officials who are charged with the administration 
of the law lose track of them or are unable to keep 
up with them. The average citizen is helpless. 
As a practical matter, in many cases the expense 
of ascertaining and enforcing an ordinary worka- 
day right is prohibitive. The individual is obliged 
to appeal to the official and meekly ask what he 
should do or refrain from doing. We are rapidly 
drifting into a system of administrative absolut- 
ism which is derived from the European idea. 
The people are losing control of their government. 
Our independent judiciary has been weakened 
and has lost respect. Its jurisdiction has been 
relatively narrowed. Incidentally, more than two- 
thirds of our federal judges have already been ap- 
pointed by one executive, and too often the ap- 
pointments have been influenced by political con- 
siderations. Our legislative bodies have been 
smeared and subordinated. They are called upon 
constantly to legislate in the interest of special 
groups without the aid of any crystallized general 
public opinion. No legislative body is equal to 
such a task. There is a growing impatience with 
our system of checks and balances, which was 
calculated to prevent governmental action unless 
it was supported by the considered opinion of the 
people. The Constitution has been stretched to 
the breaking point. The national government has 
taken over control of countless phases of our lives 
which a few years ago were considered purely 
local. The citizen now, instead of turning to his 
local city, county or state government, looks more 
and more to Washington. The people are being 
encouraged to depend more and mdre upon the 
government. The local governments are being 
made more and more subservient to the central 
government. A government far away seems 
better than one close at hand. The fact that what 
the government gives to the people, the govern- 


ment must take from the people, is overlooked. 
The fact that wealth is produced by individual 
effort and accumulated resources, .rather than by 
governmental division or printing, is ignored. 
Government loans and subsidies for si>ecial inter- 
ests have become commonplace. The government 
has undertaken the detailed regulation of private 
competitive business, and in many instances has 
itself engaged in private business. The individual 
and private enterprise are rapidly being shackled 
and enslaved by the governmental officials in 
power, who are gradually assuming the role of 
masters, charged with the duty of planning the 
political, economic, and social lives of the people. 

Such a trend, if unchecked, leads inevitably 
to the complete enslavement of the people. Under 
such a system, what is the criterion for decision? 
It cannot be on the basis of equality, because, 
while under our theory of government, all men 
are created free and equal, they cannot be kept 
equal except by restraint and servitude. You may 
pick out any number of individuals you wish, and 
start them out on an equal basis. If they are free, 
they cannot be kept on an equal basis very long. 
If they are enslaved, they will be. On the other 
hand, if the central planning authority is to decide 
on some basis other than that of equality you must 
have an arbitrary subjective decision in favor of 
some special interest. The only safe and just 
role of governmental authority is to provide rules 
of law which give each individual and each group 
a fair chance. No human agency may safely be 
entrusted with the power to determine the future 
of the people. 

The planning that I am talking about is the 
planning that leads to absolutism in government. 
No one questions the exercise of foresight or 
planning in the ordinary sense. Indeed, planning 
by the government is a good thing if it is held 
within the bounds of constitutional liberty and the 
objective rule of law. But when we destroy those 
barriers and lodge in any central authority abso- 
lute power to plan, we are on the last walk, and on 
our way to the death house. Under such planning, 
no competitive authority, no competitive activity, 
not even any competitive thinking, can be tolerated. 
Nationalization of industry means nationalization 
of thought. If we are to have comprehensive 
central planning, it is inevitably subjective plan- 
ning by one person or one group of persons for 
particular interests and purposes, and it ulti- 
mately reaches the point where the central plan- 
ning authority decides everything, even what is 
true and what is false. And so we find that in 
Germany it may be a crime even to listen to a 
radio, and in Russia, to receive a foreign magazine 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


95 


telling of the advantages enjoyed by people in 
other lands. 

The American plan of government, so wisely 
conceived, has done much to check and retard 
this trend in America, but no form of government 
is sufficient to preserve individual liberty unless 
the people continue to appreciate and to fight for 
the principles upon which that liberty depends. 

Abraham Lincoln, speaking at Springfield, in 
the neighboring state of Illinois, in regard to the 
dangers ahead of us in this country, had this to 
say : 

“At what point then is the approach of danger 
to be expected ? I answer, if it ever reach us, it 
must spring up amongst us ; it cannot come from 
abroad. If destruction be our- lot, we must our- 
selves be its author and finisher. As a nation of 
free men, we must live through all time, or die 
by suicide.” 

What can the doctors and the law}^ers do about 
this? In my judgment, they can do very much, 
and that is why I propose a marriage between the 
medical profession and the legal profession for 
the purpose of fighting for the American way of 
government. 

Other groups, while more numerous, are more 
handicapped. Political leaders are too often in- 
capacitated by egotism and ambition. They find 
it expedient, if not necessary, to coddle the public. 
Business leaders are naturally sensitive to their 
profit and loss account. They are generally in- 
timidated by the threat of confiscation of their 
capital and by the dangers of punitive investiga- 
tion and regulation. They are attracted by the 
advantage of monopoly and governmental pro- 
tection. Farmers are natural individualists and 
have stood up well against the onslaught of col- 
lectivism, but they are too much the victims of 
the weather and economic dislocations. The inter- 
est of labor is too special, and its leaders seem 
to be definitely committed to the principle of 
monopoly, without governmental control. Edu- 
cators are migratory mentally and isolated prac- 
tically. Scientists are inclined to overemphasize 
particularity, organization, and efficiency. 

The professions, and particularly the medical 
and the legal professions, have what it takes. The 
doctors and the lawyers are, above all things, 
independent. They are possessed of more than 
average information, intelligence and education. 
They know that principles and technic are not 
obstructions, but necessary aids, to genuine prog- 
ress. They have the power to reason. They have 
acquired a skill. They have had a wide and 
varied experience in human relations. They know 
human nature. They have the confidence of men 


and women in every walk of life. Although they 
desire an adequate competence, they have re- 
nounced any ambition for wealth or power. Their 
education, training, experience, skill, and influ- 
ence cannot be taken away. They are free and 
independent leaders. Above and beyond their 
professions, they are the sympathetic friends and 
confidential advisers of all mankind. If sufficient- 
ly roused, they could surely lead the people for- 
ward along the road of constitutional liberty, indi- 
vidual initiative, and private enterprise. 

The cause is worthy of their best efforts. Old 
Daniel Webster, speaking in the shadow of the 
national capitol, said : 

“Other misfortunes may be borne, or their 
effects overcome. If disastrous war should sweep 
our commerce from the ocean, another generation 
may renew it ; if it exhaust our treasury, future 
industry may replenish it ; if it desolate and lay 
waste our fields, still, under a new cultivation, 
they will grow green again, and ripen to future 
harvests. 

“It were but a trifle even if the walls of yonder 
Capitol were to crumble, if its lofty pillars should 
fall, and its gorgeous decorations be all covered by 
the dust of the valley. All these may be rebuilt. 

“But who shall reconstruct the fabric of de- 
molished government ? 

“Who shall rear again the well-proportioned 
columns of constitutional liberty? 

“Who shall frame together the skillful archi- 
tecture which unites national sovereignty with 
State rights, individual security, and Public pros- 
perity? 

“No, if these columns fall, they will be raised 
not again. Like the Coliseum and the Parthenon, 
they will be destined to a mournful and a melon- 
choly immortality. Bitterer tears, however, will 
flow over them than were ever shed over the mon- 
uments of Roman or Grecian art ; for they will be 
the monuments of a more glorious edifice than 
Greece or Rome ever saw, the edifice of constitu- 
tional American liberty.” 

Some poet once sang out : 

The period of our time is brief ; 

’Tis the red of the red rose leaf, 

’Tis the gold of the sunset sky, 

’Tis the flight of- a bird on high. 

But we may fill the space 
With such an infinite grace 
That the red will vein all time. 

And gold through the ages shine. 

And the bird fly swift and straight 
To the portals of God’s own gate. 

That is the song of individual liberty. May 
it never perish in this country of ours. 


96 


Journal ok Fowa State Medical Society 


March, 1945 


ROMANCES OF CARDIOLOGY 

Oaniel J. Gi.Ojmskt, M.D., Des Moines 

(Conliniied from last month) 


KLECTROCARnrOGRArnV 

IGeclrocardingraphy has been raised out of tlie 
Sea of the Unknown and hnilt into tlie Cape of 
Cardiology hy the toil of many giants in many 
lands. It had its heginning in a biologic laboratory 
in the University of Bologna in 1791. Biologic 
laboratories, then as now, have a variegated equip- 
ment which makes them look like junk shops. On 
a summer day in 1791 the laboratory in Bologna 
contained a 'machine for making electric sparks; 
near the generator lay a decerebrated frog, and the 
professor of anatomy, Uuigi Galvani, 4'as fussing 
about in the room. Soon someone gave the han- 
dle of the static machine a turn and the professor 
noted that the frog went into a violent muscle 
spasm. When the machine stopped, the frog lay 
quiet ; when it started again, the frog once more 
began to kick. The professor got an idea. The 
laboratory attendants w'ere sent scurrying for an 
iron rod which was put on top of the roof and 
connected with the laboratory by a wire. The 
personnel waited for the first rainy day. When 
the lightning began to flash, a prepared frog was 
touched by the wire and the same violent muscular 
twitchings were repeated — electric currents stim- 
ulated muscle. 

Fifty-three years later, in 1842, Carlo Mat- 
teucci, another Italian, working in another bio- 
logic laboratory, placed the sciatic nerve of one 
frog leg on the muscle of the other limb, stimu- 
lated the muscle of the first leg to contraction, and 
observed that the muscles of the two legs con- 
tracted together. Hence, an electric current was 
set up by muscular contraction of leg one and 
caused the other muscle to contract because it 
had been carried over to it hy the sciatic nerve. 
Fourteen years later two Swiss investigators, 
Kolliker and Muller, were able to demonstrate 
that an electric current was generated when the 
frog heart contracted. The next step in the de- 
velopment of electrocardiography was taken by 
two Englishmen, Sanderson and Page, in 1878. 
They invented a capillary electrometer by which 
die current generated in the heart could be picked 
up directly from the heart and recorded. Nine 
years afterward Professor Waller conceived the 
idea that the cardiac current could be led away 
from the body surface; he added electrodes to 
Page and Sanderson’s electrometer. 

While August D. Waller was carrying out his 
experiments with the capillary galvanometer, a col- 


league across the channel became interested in the 
electrophysiology of the heart. He was Willem 
Einthoven, professor of physiology at Leyden. 
Einthoven had a flare for electricity. He tried 
Waller’s instrument and did not like it, for the 
galvanometer was clum.sy and inaccurate. The 
column of mercury had too much inertia to record 
accuratel}' the variation of the weak cardiac cur- 
rent. But Einthoven knew of another apparatus 
made by Schweiger of the University of Hale, 
which used a string for the recording of such cur- 
rents. Einthoven also knew that Eder had made 
use of a much finer string and a more powerful 
magnet than Schweiger in a device for the detec- 
tion of the submarine. By building Eder’s idea 
into a Schweiger instrument Einthoven, in 1903, 
constructed a new form of string galvanometer 
which was accurate and 100,000 times as sensitive 
as the Eder instrument. This apparatus Eintho- 
\-en named the electrocardiograph. Many com- 
mercial firms have since made numerous models 
of the instrument, but Einthoven’s string galvan- 
ometer is still unsurpassed. During the years 1907 
and 1908 Einthoven laid the basis for electrocar- 
diography in a series of excellent papers and sent 
one of his instruments to his friend. Waller, who 
in turn invited Sir James Mackenzie to look at 
the new “electrocardiac” wonder ! 

The electrocardiograph is an instrument of pre- 
cision. Its value to clinical medicine is great. 
Yet, it might easily have remained but one of that 
motley array of scientific contraptions which form 
the armamentarium of , any modern, well -equipped, 
physiologic laboratory, and which awe and be- 
wdlder the medical student when he first sets foot 
inside of such scientific sancta. The toil and tears 
of James Mackenzie prepared the medical soil for 
electrocardiography. 

SIR JAMES MACKENZIE 

Among the real medical giants there are some 
who have hypertrophied egos, and others normal. 
But the majority of the men and women who have 
added substantially to the sum of knowledge seem 
to have possessed atrophied ego. Dr. James Mac- 
kenzie’s ego was vestigial. Up to middle age he 
believed that all doctors knew more about medicine 
than he, and after fifty he only occasionally enter- 
tained a mild doubt that the men in high places in 
medicine might actually know less than he did 
about his own life work. According to his own 
statement he was a dunce in school. When he 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


97 


graduated from Edinburgh University, he was 
so impressed by his ignorance that the best he 
hoped for was to become a mediocre general prac- 
titioner. When he began to practice, he soon dis- 
covered that he did not know enough even to be 
a general practitioner, for the complaints of the 
patients, their symptoms and signs, were utterly 
strange to him. He was to learn many years 
later that his professors were as ignorant as he 
about the phase of medicine he encountered. He 
had entered an immense virgin field in pathology 
and determined to explore it. He began to study 
the early manifestations of disease. 

It was in the mkldle of the eighties of the last 
century that Mackenzie was sitting at the bedside 
of a patient in the throes of labor. Ele had exam- 
ined her before and had found the heart sound. 
The pains were severe and the family grew more 
and more apprehensive. The prospective father 
burst into the sick room. “Is sjie all right. Doc- 
tor ?” 

“Yes.” 

“How is she doing?” 

“Splendidly.” An hour afterward the patient 
was dead from heart failure. The doctor was 
stunned, humiliated, and deeply moved. From 
that day to his death he worked incessantly and 
continuously to learn to recognize and treat dis- 
eases of the heart. Long before his death he had 
become known as the most distinguished cardiolo- 
gist in the world — the father of a second renais- 
sance in cardiology. 

After his sad experience with the woman in 
labor, he set about to make a thorough study of 
the heart in pregnancy and to make an accurate 
record of his findings. He noted that the pulse 
of some women was irregular and that there were 
various forms of irregularities. Could these have 
any significance? The books and the experts did 
not know. Mackenzie decided to find out. 'He 
secured a kymograph, a pulse tracer, in order to 
obtain permanent tracings of regular and irregular 
pulses. He noted the various types of pulse waves, 
saw the irregularities, but could not fathom their 
meaning. He also noted pulsations in the neck 
r'eins in some of the patients. What did these 
mean ? At Edinburgh his teachers had told him 
that pulsating neck veins had no clinical signifi- 
cance. But now he no longer believed in the in- 
fallibility of his teachers. He would look and see. 
Ble sweat to make an instrument that would trace 
the pulsations of the heart and the neck veins at 
the same time, only to find that an instrument 
better than his had already been invented. Mac- 
kenzie threw his own out of the window and 
lugged the other with him to all his patients, bring- 


ing back reams and reams of tracings which he 
studied at leisure. 

While looking at a tracing of one of the most 
common forms. of irregular pulse, he noted that 
the little auricular waves were absent from the 
neck tracings, and the pulse wave which was not 
preceded hy such an atrial wave was peculiar. 
The Truth Seeker understood- The irregularity 
was not a skipped lieat as he had been taught. It 
was an extra premature ventricular systole. Long 
persistent efifort was rewarded ! Later he found 
another form of irregularity in the young. This 
irregularity varied with breathing. He studied all 
his records of patients with the two types of 
arrhythmia and presented his findings before a 
society of “the would-be-great in medicine.” He 
concluded the paper with the statement that such 
irregular pulses had no clinical significance. They 
were harmless! Hardly had the speaker sat down 
when a local “giant” arose and in solemn voice 
proclaimed, “I have observed four patients of the 
type described by Dr. Mackenzie. They all died.” 
Quick as a flash the Scotsman shot back: “I have 
observed 400 patients with bald heads. They, 
too, all died.” 

Among Mackenzie’s tracings, taken from ob- 
viously sick hearts, were strips that were com- 
pletely irregular ; that is, the beats were irregular 
in height and the distance between them was not 
the same in any two beats. In such tracings he 
could not find any atrial waves. The patients 
yielding such records were short of breath, often 
coughed, and had swollen ankles. Mackenzie 
concluded that such tracings carried a bad prog- 
nosis. It was a dangerous form of arrhythmia. 
One day a former patient came to see him on busi- 
ness. Years before, the man had been very sick 
with heart trouble and had been treated by Macken- 
zie. The doctor took his pulse. It was irregular. 
He took a tracing. It showed the bad form of 
irregularity. Yet, the man was not sick ! He ex- 
amined tracings from other patients which showed 
the dangerous form of irregularity. Some of 
these also came from patients who were well or 
nearly well. It was then that he made his great- 
est discovery — it is the condition of the myocar- 
dium and not the type of pulse or murmur that 
determines the patient’s status. Patients with 
auricular paralysis, who were sick, had a rapid 
pulse. Those who felt well had a normal pulse 
rate. A rapid pulse rate wears out the cardiac 
muscle. When a murmur signified cardiac strain, 
it was dangerous — if it did not, it was of no con- 
sequence. 

This almost led Mackenzie to discard his poly- 
graph and devote all his spare time to the study of 
heart failure. He found that there were two distinct 


98 


Journal of Towa State Medical Society 


March, 1945 


kinds of heart failure : one, characterized by 

lireatlilessness, throbbing neck veins, coughing, 
an<l swelling of the limbs; the other, by pain in 
the chest upon effort. 

Thus the Scotch “dunce” extended and elevated 
the Cajic of Cardiology by (1 ) obtaining definite 
information about the early phases of the morbid 
physiology^ of the heart, (2) by making it plain, 
although not plain enough, that the cloistered 
teachers of medicine were not ideal leaders in med- 
ical ]irogress, because they lack opportunity to 
observe and study the early phases of disease. 

Mackenzie made the profession tracing-minded. 
The pseudo-giants of his day thought him one of 
them liecause of his polygraph and his tracings. 
It was during the period when tracings, so to 
speak, were in the medical air that Einthoven 
developed his electrocardiograph. Man seems to 
be suspicious of his ability to find truth by rea- 
soning alone. He hates mental labor more than 
any other form of effort, and consequently leans 
readily on any mechanical crutch offered, espe- 
cially if the crutch is complex and its product 
mysterious. Einthoven’s string galvanometer is 
very complex and its tracings are mysterious. 
Electrocardiography from its beginning had attri- 
butes that led to popularity. It is too popular 
today ! 

SIR THOMAS lewis 

Life often shapes man’s destiny in wondrous 
ways ! 

Mackenzie disliked to be called a heart special- 
ist, preferring to be known as a general practi- 
tioner because he was against over-specialization. 
He cautioned repeatedly against overemphasizing 
mechanical devices. Yet when Waller invited him 
to inspect Einthoven’s string galvanometer, James 
Mackenzie zvas the heart specialist of the world. 
Doctors, young and not so young, flocked to Lon- 
don to learn about hearts and how to take trac- 
ings from the master. When these students re- 
turned home, they brought with them more or 
less of the master’s mantle and a polygraph. Poly- 
graphs suddenly appeared in offices and clinics all 
over the world, and a crop of heart specialists 
grew lustily in many lands. 

Among Mackenzie’s pupils was a brilliant young 
Englishman, Thomas Lewis, who had a fondness 
for mathematics and graphs. With his teacher’s 
blessing Lewis journeyed to Leyden to learn from 
Einthoven the intricacies of the electrocardiograph. 
When Lewis returned to London, he brought an 
Einthoven string galvanometer back with him and 
forthwith began taking tracings from patients. 
The fruit of his labors appeared as a series of 
classic papers dealing with electrocardiography. 
The papers were striking, not only because they 


contained im]X)sing tables giving figures to 1/1000 
of a second and beautiful electrocardiograms, but 
also because they were written in lucid English. 
After a few years a little book on cardiac arrhyth- 
mia appeared. It sold like “hot dogs” and 
finally Lewis crowned his labor by publishing The 
Mechanism and Graphic Represeniation of the 
Heart Beat. It became the Bible of cardiologists. 

The publications of Sir Thomas Lewis were 
eagerly read by medical men the world over. The 
net result of the reading was that doctors, anxious 
to learn the new science of electrocardiography, 
booked passage on the first boat for London and 
Lewis. As by magic, polygraphs disappeared 
from offices, and cardiac stations and electro- 
cardiographs took their places. Journals devoted 
exclusively to cardiac research and diseases of the 
heart appeared in most civilized lands. Their 
pages were and are filled with electrocardiograms. 
At present even the cultists use the new apparatus, 
and a new super-specialist, the electrocardiograph- 
ic interpreter, has appeared in our midst. Will 
the wonders of science ever cease! 

Electrocardiography is grossly abused today. 
1 he abuse will come to an end ; its true value to 
medicine wdll remain. When that day arrives, the 
gap between clinical and anatomic diagnosis of 
heart disease will have been closed, and the Cape 
of Cardiology will have become a peninsula. 

DR. JAMES B. HERRICK 

All his medical career Dr. Mackenzie strove to 
recognize and understand morbid processes in the 
heart in order to treat heart disease rationally. 
He made use of all the available diagnostic aids 
of his day, but he used them merely as aids, not 
as substitutes, for the human brain. Time and 
time again he cautioned his colleagues against plac- 
ing too much reliance on physical equipment. He 
was hoping for a profession of master clinicians 
having good tools and clear brains. 

The most perfect example of a master clinician 
I have met is James B. Herrick of Chicago. Dr. 
Herrick early in his medical career mastered the 
available knowledge about the heart. Because he 
taught physical diagnosis at Rush he became very 
skillful in inspection, percussion, auscultation, 
and in the use of other diagnostic methods. 
Through many years of personal experience with 
the various methods, and through his close per- 
sonal association with a great pathologist, Herrick 
had ample opportunity properly to evaluate the 
signs and symptoms he observed. These qualifi- 
cations added to the fact that he is more blest 
than most men with seeing eyes, hearing ears, and 
a clear, logical mind, enabled James B. Herrick 
to lift out of the Sea of the Unknown a large 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


99 


segment of knowledge that had been lying awash 
just off the shore of the Cape of Cardiology since 
the time of Morgagni ! 

In January, 1910, Dr. Bremmerman called Dr. 
Herrick in counsel for a case of an obscure seri- 
ous illness. Herrick’s own account of his expe- 
riences with coronary thrombosis follows : 

“When I saw him twelve hours after the painful 
attack, his mind was clear and calm ; moderate 
cvanosis and mild dyspnea were present. The 
chest was full of fine and coarse moist rales : there 
was a running feeble pulse of 140. The heart 
tones were very faint and there was a most start- 
ling and confusing hyperresonance over the chest, 
the area of heart dullness being entirely obscured. 
The abdomen was tympanitic. This condition re- 
mained with slight variations up to the time of his 
sudden death, fifty-two hours after the onset of 
the pain, though at one time the rales seemed 
nearly to have disappeared. . . . That the acci- 
dent might be primarily abdominal was consid- 
ered and to help rule out some such condition 
that might call for surgical interference, we de- 
cided to call in Dr. John B. Murphy. . . . 

“At the request of the family. Dr. Murphy and 
I came back in the evening and stayed all night. 
We were in a big room with twin beds. Murphy, 
hearing me turn in bed, but not wishing to waken 
me if I were asleep, would whisper, ‘Herrick, are 
you awake? Say, are you sure about there being- 
no pneumothorax?’ A little later, from my bed, 
also in a stage whisper : ‘Dr. Murphy, do 3 mu 
think this might be an acute pancreatitis, or pos- 
sibly a strangulated diaphragmatic hernia?’ 
Neither of us slept much. We got up once or 
twice during the night to look at the patient. 

“As recorded in the history, the patient, with 
little suffering and with little change in condition, 
lived until about 4:00 a. m., January 18, when sud- 
denly the heart and breathing stopped. The au- 
topsy by Dr. Hektoen was performed the same 
day. I was unable to be present. Dr. Hektoen 
asked me over the telephone what he might ex- 
pect to find. My reply was, ‘Look for a clot in 
the coronary artery. If you don’t find that, find 
a perforated gallbladder or a perforating duodenal 
ulcer, hemorrhagic pancreatitis, hemorrhage into 
the adrenals, strangulated hernia, perhaps a dia- 
phragmatic hernia, ruptured pleura, or any other 
accident you know about.’ Dr. Hektoen, with the 
dry humor for which he is well known, with mock 
courtesy thanked me for giving him such a great 
variety to choose from. He called me up that 
evening and said : ‘The clot was in the coronary 
artery, all right. But how in God’s name did you 
guess it ?’ Perhaps guess was the right word. . . . 

“It is evident that, long before May, 1912, when 


I read my paper at the Association of American 
Physicians, I had become much surer of my 
ground, for, in May, 1911, at Des Moines, in the 
course of an address on ‘Pain in Disease of the 
Heart,’ delivered before the Section on Medicine 
of the Iowa State Medical Society, I devoted about 
1,500 words to acute obstruction of the coronary 
artery. . . . The concluding paragraph is perhaps 
worth quoting — as it shows that my ideas at that 
time were pretty well crystallized, . . . 

“ ‘This address, if it accomplishes its aim, will 
encourage the specialist and the research worker 
to go forward with the use of the newer instru- 
ments and with the investigations by which new 
facts concerning the heart will come to light. It 
will also, I trust, encourage the general practitioner 
to retain some of his old self-confidence and not 
to. lose faith in his powers of observation and in 
his ability to analyze subjective symptoms: and 
still to believe that it is possible by well-established 
methods of physical diagnosis to understand many 
of the anatomic pathologic and physiologic condi- 
tions of this important organ.’ 

“It seemed strange to me at the time, it seems 
strange to me now, that when, in 1912. I read be- 
fore the Association of American Physicians a 
paper that seemed to me to contain an important 
announcement, it fell like a dud. No one, except 
Emanuel Libman, discussed it or even asked a 
question. I must have been keyed up to a high 
pitch, for I recall my eagerness to have the article 
published promptly ; I feared someone else might 
jump into print ahead of me. My anxiety about 
priority was groundless. Even after its publica- 
tion in the Journal of the American Medical Asso- 
ciation, in December, 1912, it aroused no more 
comment than it did when it had been read, six 
months before. No really live interest in the topic 
was manifested until the second paper, on ‘Throm- 
bosis of the Coronary Arteries,’ was read before 
the association in 1918. This contained reports 
on two other patients, with the autopsy findings. 
It contained, besides, a record of Dr. Fred M. 
Smith’s laboratory experiments on dogs, with lan- 
tern slides of electrocardiograms and pathologic 
specimens. In those days, and it is often true to- 
day, a lantern slide of a graph, or an experiment 
on a dog in a laboratory, attracted greater atten- 
tion than mere observations made at the bedside 
on human beings. 

“It is surprising how easy it is, as Isaiah noted 
long ago (Isaiah 42:20), to hear but not under- 
stand, to see but not really observe. We are all 
human ; we have all erred in this respect. At times 
I wondered why my early paper had attracted no 
attention ; why my Des Moines address had appar- 
ently fallen on deaf ears. . . . 


100 


Journal of Iowa State Medical Society 


March, 1945 


“By the end of 1910, and especially after 1911, 
when 1 read the paper in Des Moines, I began con- 
sciously to do what T called missionary work, 
preaching the gospel of the pathology and clinical 
symptoms of acute coronary obstruction. In lec- 
tures to students, in clinics, in consultations with 
physicians and in talks before medical societies in 
Chicago and elsewhere, I talked coronary occlu- 
sion almost ad nauseam. A few listened atten- 
tively, more incredulously, the majority, indiffer- 
ently. I recall an informal talk before a meeting 
of Western Surgeons in the Rush amphitheater, 
in which I stressed the resemblance of the accident 
to acute abdominal surgical conditions. I can still 
see the quizzical look on Charlie Mayo’s face, as 
from a front seat, he listened to, but was evidently 
not converted, by my sermon. ... 

“An interesting episode may be mentioned, as 
showing the attitude of mind of even excellent 
men at that time. My patient, the doctor, after 
his first interview with me, went to make a social 
and semiprofessional visit on a prominent col- 
league in a large western cit}L When my diag- 
nosis of coronary thrombosis was mentioned, the 
colleague emphatically said that neither Dr. Her- 
rick nor any one else was justified in making such 
a diagnosis except on the autopsy table. The at- 
tempt was ridiculous because it was impossible. 

Thus, Herrick clarified and completed the con- 
cept of coronary disease, and revealed it the mon- 
ster of iniquity it is. Today any senior medical 
student can make a correct diagnosis of the cor- 
onary syndrome. And the effect of Herrick’s “ad 
nauseam teaching’’ is shown dramatically each 
week in the list of death notices that appear in the 
Joimial of the American Medical Association. 

cardiac therapy 

The foregoing paragraphs of this .little story 
have dealt with the acquisition of knowledge con- 
cerning the nature and detection of cardiac disor- 
ders. However, the prime interest of clinician 
and patient centers around the prevention and cure 
of cardiac diseases, and the alleviation of suffering 
caused by them. The rest of this account will be 
devoted to a discussion of the development of 
cardiac therapy and of giants whose toil brought 
it about. 

It is obvious that during the dark ages, when 
the heart was considered immune to disease, there 
could be no therapeutic advance. Yet, even then 
effective treatment was practiced inadvertently ; 
Physicians had sense enough to keep their pa- 
tients supine as long as they were short of breath, 
and to administer opium for their pain. As late 
as the eighteenth century cardiac treatment was 


crude and emi)iric, often doing more harm than 
good. The blood-letting, cupping, and leaching, 
which appear to have been standard procedures, 
were on the whole either worthless or harmful, 
and the rigorous mercurial treatment for lesions, 
thought to be syphilitic, did so much harm that the 
pathologist often was at a loss to ascribe the mor- 
bid changes to syphilis or to mercury poisoning. 
When, in 1773, John Hunter began to have at- 
tacks of cardiac pain, the treatment was as fol- 
lows: “Pie changed his position, sitting down, 
walking, laying himself down on a carpet, then 
upon chairs. He took a spoonful of tincture of 
rhubarb with 30 drops of laudanum. Later he 
took madeira, brandy, ginger. During another 
attack 8 ounces of blood was taken away ; he was 
cupped between the shoulders, and a large blister 
applied. He took an emetic ; several times he took 
purging medicine: bathed his feet in hot water; 
took some James powder; and drank white wine. 
At another time Dr. Pitrain prescribed 10 grains 
asafoetida, 3 grains opium, laxative clysters and 
10 grains jalop. Then Sir George Baker, Drs. 
Warren and Pitrain repeated the asafoetida twice 
and gave 

Rx Infus. Senna oz. 6 

Tinct. Senna drams \y 2 

Soluble tartar drams 3 

Sig. 2 teaspoonfuls every hour. 

He also took cinnamon water, oleum succine, 
warm tinct. of rhubarb and baume de vie, etc.” 

WILLIAM withering 

Eleven years before John Hunter took his self- 
administered empiric treatment for cardiac pain, 
there enrolled in the medical school at Edinburgh, 
made famous by the sweat, blood, and toil of such 
men as the Monroes, Cullen, and Fothergill, a 
doctor’s son from Shropshire, England. This' lad 
was William Withering. Botany was a compul- 
sory study at the medical school. Young Wither- 
ing did not like botany. Nevertheless, he received 
the professors’ gold medal at the end of the course 
(1764). Yet, he wrote to his parents: “It (the 
medal) will hardly have charms enough to banish 
the disagreeable feeling I have formed from the 
study of botany.” In 1766 he began his practice 
at Stafford near his home. In that city there 
lived a young lady, Helena Cooke, whose hobby 
was the painting of flowers. Is it possible that 
this daughter of Eve’s interest in flower painting 
was a bit sharpened when she learned that a hand- 
some young doctor who had won a gold medal in 
botany had -come to town ? And could it be that 
when she came to his office as a patient she com- 
plained of what difficulty she had in finding the 
correct names for the wild flowers she painted? 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


101 


At an\- rate, in the words of Meakins, she l)ecanie 
a patient “to whom he would appear to have had 
a safer attachment than that engendered by a 
lucrative patient.” 

In order to impress* this very desirable patient, 
we may l)e reasonably sure that he reviewed his 
texts on botany and brought her flowers to paint 
during her convalescence. Later on, the two prob- 
ably took walks through the beautiful English 
countryside, and he could not have been a true 
son of Adam unless he displayed his botanical 
knowledge to his lady by telling what he knew 
about the plants they encountered on their walks. 
Looked at in their light liotanizing became a de- 
lightful experience — and profitable, too, for in 
the year 1772 the two were married, and in 1776 
Withering published his Arrauge\ments of British 
Plants. It was the first British textbook of bot- 
any. 

When the tedious work essential to the publica- 
tion of his botany drew to a close. Withering must 
have been weary once more of the study of plants. 
He had many irons in the fire. He liked to play 
the flute and read poetry. He was interested in 
mineralogy, and Priestley had engendered in him 
an enthusiasm for chemistry. Perhaps most im- 
portant of all, there was by 1774 “’Im and ’Er and 
It.” He must increase his income. At the insti- 
gation of that sour-puss, Erasmus Darwin, With- 
ering moved to the industrial city of Birmingham 
(1775). Financially he improved himself at 
Birmingham, and must have thought himself rid 
of botany forever when he sent his British Vege- 
tables to the publishers. But he wasn’t ! 

In the infirmary at Stafford and in his private 
practice he had often encountered cases of dropsy. 
The causes of dropsy were not understood in that 
day. He had treated his cases as empirically as 
John Hunter treated himself for his cardiac pain 
in 1773 — and did not get even as good results as 
Hunter had from his 30 drops of laudanum and 
brandy. Neither Withering nor the other practi- 
tioners benefited the dropsical patients very much. 
Hence, sooner or later some of them drifted over 
to an old herb-woman in Withering’s home coun- 
try. She cured the patients by the use of a 
medical vegetable soup containing 20 different 
herbs which caused violent vomiting and purging. 
The botanist-doctor suspected that foxglove was 
the active ingredient of the herb medicine and, dur- 
ing his first year in Birmingham, began to ex- 
periment with it on turkeys and man. 

At first he used a decoction, then an infusion. 
The latter was gradually abandoned in favor of a 
beautiful green powder which he made from the 
dried leaves. The dose, either in powder or pill 
form, was one grain twice a day. He stopped 


the drug when it acted upon the kidneys, the stom- 
ach, the pulse, or the bowels. 

Withering was called in consultation to see the 
dean of a local church who was water-logged, short 
of breath, and had an irregular pulse. The older 
doctors in attendance had tried the various stand- 
ard remedies of the day but to no avail. Wither- 
ing prescribed digitalis. The dean recovered. 
Erasmus Darwin had a woman who also suffered 
from congestive heart failure. He called Wither- 
ing in counsel. Again digitalis was prescribed, the 
patient’s pulse became steady, and she went back 
to work. Darwin reported the case and later 
claimed that he and not Withering, whom he vio- 
lently denounced as an imposter, had discovered 
the use of digitalis. 

While Withering continued his experiments and 
careful observation on the use of the foxglove the 
drug became alamode for all sorts of illnesses. 
As happens with any new “key” in medicine, it 
was tried on all therapeutically-locked doors. But 
it was administered in too large doses so that the 
toxic eff'ect became conspicuous among the digital- 
ized sick. Because of the abuse of the drug. 
Withering’s friends urged him to publish his own 
observations on it. In 1785 An Account of the 
Foxglove and Some of its Medical Uses appeared. 
The “Account” represents the beginning of ra- 
tional cardiac therapy; Withering extended the 
Cape of Cardiology far out into the Sea of the 
Unknown. But, because of the initial abuse of the 
foxglove, it fell into disrepute from which it was 
not rescued until our own era. Todav, it is the 
keystone in the arch of cardiac therapy. 

PAUL EHRLICH 

Attention has already been called to the discov- 
ery of America as one of the first fruits of the 
Renaissance. The sailors of Columbus brought 
back a vastly enlarged world. They also brought 
back syphilis. The loathsome venereal disease 
spread through Spain, France, and into Italy with 
amazing rapidity. Before a century had passed, 
that white plague had been planted in every nook 
and corner of the globe by sinning white folk. At 
the end of the nineteenth century the disease was 
so prevalent that every medical student was famil- 
iar with its polymorphous manifestations. He 
knew the rashes of syphilis, had seen the deep 
ulcers that at times penetrated the skull and 
sloughed off the entire nose. He was familiar 
with the acute syphilitic meningitis that caused 
death and knew very well that every asylum housed 
hopelessly insane syphilitics. Mothers, many of 
them, learned that the disease killed babies in their 
wombs, even blinded their offspring after chil- 
dren had grown up, apparently healthy. Even to- 


102 


Journal of Iowa State Medical , Sociktv 


March, 1945 


(lay, this terril)lc disease is res]ionsil)le for nearly 
10 per cent of premature cardiac failure. Syphil- 
is attacks the wall of the aorta and causes sudden 
death from hemorrhage. It destroys the valves 
of that great vessel often causing the victim to die 
before he reaches middle age. 

During the last third of the nineteenth century 
when hard working bacteriologists were discover- 
ing by the dozens the germs that are responsible 
for infections, many looked long and hard for the 
cause of syphilis. But the germ eluded the search- 
ers. When the last century came to a close, the 
cause of the disease was unknown. However, at 
that time there lived in Hamburg a zoologist who 
was director of the Kaiserliches Gesundheitsamt. 
This man was Fritz Schaudinn who had devoted 
his professional life to the study of protpzoa. None 
was more skillful ; none had tackled research prob- 
lems with more intelligence and industry than did 
Fritz Schaudinn. In 1905 he and Erich Floffmann 
were applying to syphilitic material a new tech- 
nic for staining flagellates in tissue. There they 
came upon delicate corkscrew shaped organisms 
lying among the cells. Could it be ? The work was 
repeated. Again they saw spirochetes. The two 
men worked feverishly until they were certain ! 
Schaudinn sent his material to his American col- 
league, the late Dr. Novy of the University of 
Michigan, and received a go-ahead cable. The 
cause of syphilis had been found. 

At the time that Schaudinn and Hoffmann were 
making doubly sure that they were dealing with 
the real organism of syphilis, there walked about 
in the Serum Institute in Frankfurt am Main a 
gesticulating man in horn-rimmed spectacles. That 
man had sat in Berlin in the year 1882 and lis- 
tened to Robert Koch lecture on the tubercle ba- 
cillus. It was the most momentous evening of his 
life. “From that evening on, Koch -became his 
God, and the fighting of infections his life work.” 
That Jew, Paul Ehrlich, fought hard ; first in 
Koch’s laboratory where Koch’s special bug al- 
most got him. He had to go to Egypt to regain 
his health. When he came back, he continued his 
fight against germs. At the time Schaudinn dis- 
covered the pale spirochetes, Ehrlich had obtained 
“Geld,” he had developed some “Geduld,” and was 
about to have the “Gliick” he so richly deserved ; 
for, in 1905 a rich Jewish widow had donated 
enough money to build him an Institute, well 
equipped and well staffed, and Ehrlich was the 
Herr Direktor. He still walked about, puffing 
expensive cigars, gesticulating, and making sketch- 
es to illustrate his theories. Ehrlich was a cellu- 
lar chemist, he believed “La vie est une fonction 
chimique.” His “idee fixe” was : “We must learn 


to shoot microbes with magic bullets.” Hence, his 
enemies called him Doktor Phantasus. 

At hrankfurt Ehrlich, who read everything he 
could obtain on immunity and chemistry, had 
noted that Von Behring’s antitoxins had failed to 
cure all infections and that Pasteur’s hope for vac- 
cines was not to be fulfilled. He, therefore, staked 
his all on finding his magic bullet in chemistry. 
He had moved to Prankfurt to lie near its great 
dye works and their master chemists. lie loved 
the colors of dyes and ever since he had injected 
methylene blue into the ear veins of a rabbit and 
found that the dye stained only the nerve tissue, 
the crazy Jew believed that somehow his magic 
bullet could be cast by making a chemical that 
would be harmless to the host’s tissue but would 
kill the germ. Laveran’s work on the trypano- 
somes furnished him his first clue. The flagellates 
could be readily seen ; they killed mice with ease. 
Laveran had tried to kill the microbes with arsen- 
ic; but arsenic killed the trypanosomes and the 
mice. He would try to change arsenic com- 
pounds into magic bullets. He tried 500 dyes 
containing arsenic ; none worked. He would 
change them a little, attach the sulfa group to the 
benzopurpurine. Fie injected the soluble, new 
chemical. One single mouse failed to die from 
the trypanosome injection. It was his first suc- 
cess. But it was only one! All subsequent mice 
died in spite of his injections. The dyes did not 
work ; but Paul Ehrlich did 1 He read and read 
all he could find on poisonous chemicals that could 
be changed a little. He read about atoxyl, a foxy 
name for an arsenic compound supposedly non- 
poisonous that almost cured animals and people 
from sleeping sickness. Yes, but it was poison- 
ous, it killed mice, and made darkies go stone blind. 
Maybe it could be changed a little. But, no, it 
was supposed to be one of those unchangeable 
compounds ! Ehrlich would try to change it any- 
how ! And Paul Ehrlich found a way to change 
atoxyl. Then the excitable man went wild. May- 
be it could be changed into a thousand compounds 
of arsenic. Change atoxyl they did, the workers 
at that institute, and found one compound that 
killed the flagellates. The whole personnel of the 
Institute went as nutty as the Herr Direktor, but 
the cured mice died after a few days from anemia 
and jaundice. On they worked at Ehrlich’s insti- 
tute, 100 experiments, 200, 300, 400, 500, 600 
experiments. The quest was “getting warm.” 
Then came 606 — that did it! The mice were 
cured and remained healthy. It was about this 
time that Paul Ehrlich read about Schaudinn’s 
pale spirochetes — which closely resemble trypano- 
somes. 

The rest has been told a thousand times. Sal- 

(Continued on page 114) 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


103 


m 


As of 

Adair County 

Cornell, D. D., Greenfield (APO 41, San Francisco, 

Cal.) Capt., 

Gantz, A. J., Greenfield (APO 951, San Francisco, 

Cal.) Capt., 

Adams County 

Bain, C. L., Corning (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., XI. 

Willett. W. J., Carbon (APO 230, New York. N. Y.).Capt., 
Allamakee County 
Hogan, P. W.. Waukon 

Ivens, M. H., Waukon (Miami Beach, Fla.) Capt., 

Kiesau, M. F., Postville (Jefferson Barracks, Mo.).. Major, 

Rominger, C. R., Waukon (Camp Claiborne, La.) 

Appanoose County 

Condon. F. J., Centerville (Owensboro. Ky.) . .Major. U.S. 

Edwards, R. R., Centerville (Richmond, Va.) (japt., 

Huston, M. D., Centerville (Camp Bowie, Texas) .. Capt., 
Audubon County 

Koehne, F. D.. Audubon (APO 520, New York, 

N. Y.) Major, 

Benton County 

Koontz, L. W., Vinton (APO 7. San Francisco, Cal.) Capt., 
Senfeld, Sidney, Belle Plaine 

Black Hawk County 

Bickley, D. W„ Waterloo (APO New York, N. Y.).Capt., 
Bickley, J. W„ Waterloo (APO 966, San Francisco, 

Cal.) Capt. 

Butts. J. H.. Waterloo (Galveston, Texas) Comdr., U 

Cooper, C. N., Waterloo Lt. Comdr., U, 

Ericsson, M. G., Cedar Falls (Camp Barkeley, Tex.) Capt., 
Hartman, H. J., Waterloo (APO 33, San Francisco, 

Cal.) Capt., 

Henderson, L. J., Cedar Falls (APO 782, 

New York, N. Y.) Major, 

Hoyt. C. N., Cedar Falls (APO 635, New York, 

N. Y.) Capt., 

Ludwick, A. L., Waterloo (Abilene, Texas) Major, 

Marquis, F. M., Waterloo (APO 17321, New York, 

N. Y.) Capt., 

O’Keefe, P. T., Waterloo (APO 79, New York, 

N. Y.) Capt., 

Paige, R. T., LaPorte City (Banana River, Fla.) .Comdr., U 
Rohlf, E. L., Jr., Waterloo (APO 230, New York, 

N. Y.) Major, 

Seibert, C. W., Waterloo (Colorado Springs, Colo.) . .Major, 
Smith, E. E., Waterloo (APO 709, San Francisco, Cal.) 

. Major, 

Smith, R. I., Waterloo (Milwaukee, Wis.) Capt., 

Smith, R. G., Cedar Falls (APO 612, New York, 

N. Y.) Major, 

Trunnell, T. L., Waterloo (Parris Island, S. Car.) Lt. U, 

Boone County 

Brewster, E. S., Boone (APO 446, New York, N. Y.) .Major, 

Healy, M. J., Boone (Camp Chaffee, Ark.) Capt., 

Shane, R. S., Pilot Mound (Des Moines, la.) Lt. Col., 

Bremer County 

Blum, O. S., Waverly (Fleet PO, San Francisco, 

Cal.) Lt., U 

Bathe, H. W., Waverly (APO 209, New York, N. Y.) 

Major, 

Shaw, R. E., Waverly (Long Beach. Cal.) 1st Lt., 

Buchanan County 

Barton, J. C., Independence (APO 314, New York, 

N. Y.) Lt. Col., 

Hersey, N. L., Independence (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U 

Leehey, P. J., Independence (APO 244, San Francisco, 

Cal.) Capt., 

Loeck, J. F., Aurora (APO 9787, New York, N. Y.) . .Capt., 

Buena Vista County 

Almquist, R. E., Albert City (APO 43, San Francisco, 

Cal.) Capt., 

Brecher, P. W., Storm Lake (Camp Adair, Ore.). .Lt. Col., 

Hansen, R. R., Storm Lake (Farragut, Idaho) Lt., U, 

Mailliard, R. E., Storm Lake (APO 254, New York, 

N. Y.) Lt. Col.. 

Shope, C. D., Storm Lake (Fort Des Moines, la.).. Capt., 
Witte. H. J., Marathon (Fort Crook, Nebr.) Major, 

Butler County 

Andersen. B. V., Greene (Fleet PO. Seattle, Wash).Lt., U 
James, R. A., Allison (Mare Island, Cal.) 

Rolfs, F. O.. Parkersburg (Springfield, Mo.) 1st Lt., 

Calhoun County 

Grinley, A. V., Rockwell City (APO 360, New York, 

N. Y.) Capt., 

Hobart, F. W., Lake City (Camp Grant, 111.) Capt., 

McVay, M. J.. Lake City (Waco, Texas) Capt., 


February 23, 1945 

Peek, L. H., Lake City (Jefferson Barracks, Mo.) . .Capt., A. U.S. 
Stevenson, W. W., Rockwell City (Fleet PO, San 

A TT c Francisco, Cal.) Comdr., U.S. N.R. 

Weyer, J. J., Lohrville (APO 465, New York, 

A.U.S. N. Y.) Capt., AU.S. 

Carroll County 

Anneberg, A. R., Carroll (Camp Barkeley, Texas) A.U.S. 

S.N.R. Anneberg. W. A., Carroll (APO 367, New York, 

A.U.S. N. Y.) Capt., A.U.S. 

Cochran, J. L., Carroll (Gulfport, Miss.) 

Cross, D. L.. Coon Rapids (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

A.U.S. Freedland, Maurice, Coon Rapids 

A-U.S. Morrison, J. R.. Carroll (Ft. Dix, N. J.) Capt., A.U.S. 

A.U.S. Morrison. R. B., Carroll (APO 634, New York, 

N. Y.) Capt., A.U.S. 

.P.H.S. Pascoe, P. L.. Carroll (Bowman Field. Ky.) Capt., A.U.S. 

a!u.S Scannell, R. C., Carroll (Denver, Colo.) Capt., A.U.S. 

a Vt's Tindall, R. N., Coon Rapids (Hines, IlL) Major, A.U.S. 

Wyatt, M. R., Manning (Stuttgart, Ark.) Capt., A.U.S. 

Cass County 

A.U.S. Egbert, D. S., Atlantic (APO 218, New York N. Y.) 

Major. A.U.S. 

, _ Needles, R. M.. Atlantic (APO 131, New York. 

A.U.S. N. Y.) , Capt., A.U.S. 

Petersen. M. T., Atlantic (Topeka, Kan.) Capt., A.U.S. 

Schiff, Joseph, Anita (Walla Walla, Wash.) 1st Lt., A.U.S. 

Cedar County 

A TT Q Laughlin, R. M., Tipton (San Diego, Cal.) Lt., U.S.N.B. 

Mosher, M. L., West Branch (APO 560, New York, 

SNR N. Y.) Capt., A.U.S. 

A U S O’Neal, H. E., Tipton (Camp Maxey, Texas) Lt. CoI„ A.U.S. 

Cerro Gordo County 

Adams, C. O., Mason City (Vancouver, Wash.l Capt., A.U.S. 

A TT d Egloff, W. C., Mason City (APO 17130, New York, 

A.u.b. N. Y.) Capt., A.U.S. 

A TT S Flickinger, R. R., Mason City (Memphis, Tenn.) . . . .Capt., A.U.S. 

A U S Hale, A. E., Dougherty (Atlanta, Ga.) Capt., A.U.S. 

Harris, R. H., Mason City (Dyersburg, Tenn.) Capt., A.U.S. 

A TT e Harrison, G. E„ Mason (jity (APO 365, New York, 

A.U.b. Y.) Col., A.U.S. 

A TT s Houlahan, J. E., Mason City (APO 838, New Orleans, 

La.) Capt., A.U.S. 

.o.jx.n. Lannon, J. W., Clear Lake (APO 230, New York, 

A TT d N. Y.) Capt., A.U.S. 

Long, D. L„ Mason City (APO 620, New York, 

A.U.S. N. Y.) Capt.,A.U.S. 

A TT <3 Morgan, P. W., Mason City (Camp Butner, 

2-fld' N. Car.) Capt., A.U.S. 

Sternhill, Irving, Mason City (Ayer, Mass.) Capt., A.U.S. 

A.U.S. Cherokee County 

S.N.R. Bullock, G. D., Washta (APO 17583, New York, 

N. Y.) Capt., A.U.S. 

A.U.S. Ihle, C. W., Jr., Cleghorn (APO 6, San Francisco, 

A.U.S. Cal.) Major, A.U.S. 

A.U.S. Swift, C. H., Jr., Marcus (APO 201, San Francisco, 

Cal.) Capt.. A.U.S 

Chickasaw County 

.S.N.R. Caulfield, J. D., New Hampton (APO 178, New York, N. Y.) 

Major, A.U.S. 

A.U.S. Murphey, A. L., Fredericksburg (Hot Springs, Ark.) Capt., A.U.S. 
A.U.S. O’Connor, E. C., New Hampton (Redmond, Ore.) .. .Capt., A.U.S. 
Richmond, P. C., New Hampton (APO 88, New York, 

N. Y.) Major, A.U.S 

A.U.S. Clarke County 

Armitage, G. I.. Murray (Carlisle Barracks. Pa.) .. 1st Lt., A.U.S. 

S.N.R. 

Clay County 

A.U.S. Edington, F. D., Spencer (APO 649, New York, 

A.U.S. N. Y.) Col., A.U.S. 

Jones. C. C., Spencer (Fleet PO. San Francisco, 

.Cal.) Lt., U.S.N.R. 

^ ^ g King, D. H . Spencer (Peterson Field, Colo.) Capt., A.U.S. 

A.U.S. Clayton County 

S.N.R. Andersen, H. M., Strawberry Point (Camp Crowder, 

A.U.S Mo.) Capt., A.U.S. 

a!u!s! Glesne. O. G.. Monona (Knoxville. Iowa) Capt., A.U.S. 

A U S Rhomberg, E. B., Guttenberg (APO 684, New York, 

■ ■ ■ N. Y.) Capt., A.U.& 

g p Clinton County 

Amesbury, H. A., Clinton (Vancouver, Wash.) Capt., A.U.S. 

A.U.S. Burke, J. C., Clinton (Great Bend, Kan.) A.U.S. 

Ellison, G. M., Clinton (APO 9030, New York, 

N. Y.) Capt., A.U.S. 

Hill, D. E., Clinton (APO 9787, New York, N. Y.) . . .Capt., A.U.S. 
A.U.S. King. R. C.. Clinton (APO 403. New York, N. Y.)...Capt. A.U.S. 
A.U.S. Lenaghan, K. T., Clinton (Fleet PO, San Fran- 
A.U.S. cisco. Cal.) Lt. Comdr., U.S.N.R. 


104 


joruNAi, OF Iowa Static Mkdical Socikty 


March, 1945 


Norment, J. E., Clinton (Washington, D. C.) 

Lt. Comdr., U.S.N.R. 

Riedesel, E. V., Wheatland (Fort Douglas, Utah) 

Scanlan. G. C.. DeWitt (Carlisle Barracks. Pa.) . . . .Capt., A.U.S. 

Snyder, D. C., De Witt (Al’O 520, New York, N. Y,) ,Capt„ A,U,S, 

Speigel, I, J.. Clinton (Galesburg, 111.) Capt., A.U.S. 

Van Epps. E. F., Clinton (APO 9921, New York, 

N. Y.) Capt., A.U.S. 

Waggoner. C. V., Clinton (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Wells. L. L„ Clinton (APO 562, New York. N. Y.) . .Capt., A.U.S. 

Crawford County- 

Fee. C. H., Denison (APO 696, New York, N. Y.) .Major, A.U.S. 

Grau, A. H., Denison, (Fleet PO, San Francisco. 

Cal.) Lt. Comdr., U.S.N.R. 

Maire, E. J.. Vail (APO 18085, New York, N. Y.) . . .Capt., A.U.S. 

Wetrich, M. F., Manilla (APO 986, Seattle, Wash.) . .Capt., A.U.S 

Dnilns-Guthrie Countlea 

Butterfield, E. T., Dallas Center (Fort Sheridan. 

111.) 1st Lt., A.U.S. 

Byrnes, A. W.. Guthrie Center (Fort Custer, Mich.) .Major, A.U.S. 

Fail, C. S., Adel (Fleet PO, San Francisco, Cal.) Lt U.S.N.R. 

Margolin, J. M., Perry (APO 5816, New York, 

N. Y.) .; Capt., A.U.S. 

McGilvra. R. I., Guthrie Center (Ames, Iowa) Lt., U.S.N.R. 

Mullmann. A. J., Adel (APO 565, San I'Yan- 

cisco. Cal.) Capt., A.U.S. 

Nicoll, C. A., Panora (APO 349, New York, N. Y.) . .Major, A.U.S. 

Osborn, C. R., Dexter (Fleet PO, San Francisco, 

Cal.) kLt., U.S.N.R. 

Todd, D. W., Guthrie Center (APO 2, New York, 

N. Y.) Capt., A.U.S. 

Wilke, F. A., Woodward Capt., A.U.S. 

Davis County 

Fenton, C. D., Bloomfield (APO 5253, New York, 

N. Y.) Capt„A.U.S. 

Gilfillan, G. W„ Bloomfield (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Decatur County 

Garnet, E. E., Lamoni (APO New York, N, Y.) ... .Capt., A.U.S. 

Delaware County 

Baumgarten, Oscar, Earlville (APO 689, New York, 

N. Y.) Qapt., A.U.S. 

Clark, R. E., Manchester (APO 419, New York, N. Y.) 

Capt., A.U.S. 

Des Moines County 

Eigenfeld, M. L., Burlington (Cleveland, Ohio) 1st Lt„ A.U.S. 

Heitzman, P. O., Burlington (Fort Lewis, Wash.) . . .Capt., A.U.S. 

Jenkins, (3. D., Burlington (West Point, N. Y.) .. .Lt. Col., A.U.S. 

Lohmann, C. J., Burlington (APO 708, San Fran- 
eisco. Cal.) ,i Major, A.U.S. 

McKitterick, J. C., Burlington (Hamilton, 

R. I.) Comdr., U.S.N.R. 

Moerke, R. F., Burlington (APO 565, San Francisco, 

Cal.) Clapt., A.U.S. 

Sage, E. C„ Burlington (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Dickinson County 

Buchanan, J. J., Milford (Santa Ana, Cal.) Lt., U.S.N.R. 

Henning, G. G., Milford (APO 96, San Francisco, 

Cal.) Major, A.U.S. 

Nicholson, C. G., Spirit Lake (Sawtelle. Cal.) Capt., A.U.S. 

Rodawig, D. F., Spirit Lake (Topeka, Kan.) Major, A.U.S. 

Dubuque County 

Anderson, E. E., Dubuque (Bradley Field, Conn.) .. .Capt., A.U,S. 

Beddoes, M. G., Cascade (APO 709, San Francisco, ' 

Cal.) Capt., A.Ll.S. 

Conzett, D. C., Dubuque (APO 887, New York, 

N. Y.) Lt. Col., A.U.S. 

Cunningham, J. C., Dubuque (Fairfield, Ohio) Capt., A.U.S. 

Edstrom, Henry, Dubuque (APO 645, New York, N. Y.) 

Major, A.U.S. 

Entringer, A. J., Dubuque (APO 41, San Francisco, 

Cal.) Capt., A.U.S. 

Hall, C. B., Dubuque (Camp Shelby, Miss.) Capt., A.U.S. 

Knoll, A. H., Dubuque (San Francisco, Cal.) Major, A.U.S. 

Langford, W. R., Epworth (Miami Beach, Fla,) ... .Capt., A.U.S. 

Lavery, H. B., Dubuque ( Washinprton. D. C.) Lt. Col., A.U.S 

Leik, D. W., Dubuque (Wichita Falls, Tex.) Capt., A.U.S. 

Mueller, J. J., Dubuque (APO 230. New York, N. Y.) .Capt., A.U.S. 

Olson, P. F., Dubuque (Mare Island, Cal.) . .Lt. Comdr., U.S.N.R. 

Painter, R. C„ Dubuque (Salt Lake City, Utah) Lt., U.S.N.R. 

Paulus, J. W., Dubuque (APO 116, New York, 

N. Y.) Capt., A.U.S. 

Flankers, A. G., Dubuque (APO 363 New York, 

N. Y.) Lt. Col., A.U.S. 

Quinn. E. P., Dubuque (Brentwood, L. I.) Major, A.U.S. 

Scharle, Theodore, Dubuque (APO 17670, New York, 

N. Y.) Capt., A.U.S. 

Schueller, C. J., Dubuque (APO 758, New York, 

N. Y.) 1st Lt., A.U.S. 

Sharpe, D. C., Dubuque (APO 5641, New York, 

N. Y.) Major, A.U.S. 

Smith, C. W., Dubuque (Shoemaker, Cal.) Lt., U.S.N.R. 

Steffens. L. F., Dubuque (Camp Chaffee, Ark.)...Lt. Col., A.U.S. 

Straub, J. J., Dubuque (Corpus Christi, Texas) ... .Lt., U.S.N.R. 

Ward, D. F., Dubuque (CJreat Lakes, 111.) . . . .Lt. Comdr., U.S.N.R. 


bliiiniel County 

Clark, J. P.. Estherville (APO New York, N. Y.) . .Capt., A.U.S. 

Collins. L. E., Estherville (APO 247, San Fran- 
cisco, Cal.) 1st Lt.. A.U.S. 

Miller. O. H., Estherville (Seattle. Wash.)..Lt. Comdr., U.S.N.R. 

Fayette County 

Gallagher, J. P., Oelwein (Fleet PO, San Francisco. 

Cal.) Lt., U.S.N.R. 

Henderson, W. B., Oelwein (St. Louis, Mo.) Lt Col., A.U.S. 

Sulzbach, j. F., Oelwein 

Walsh, W. E., Hawkeye (Fleet PO. San Francisco, 

Cal.) Lt. Comdr., U.S.N.R 

Floyd County 

Baltzell, W. C., Charles City (APO 2. New York, 

N. Y.) Major, A.U.S. 

Flater, N. C.. Floyd (APO 360. New York, N. Y.) .Capt., A.U.S. 

Knight, R. A., Rockford (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Mackie, D. G., Charles City (APO 216, New York, 

N. Y.l Capt., A.U.S. 

Miner, J. B., Jr., Charles City (San Diego, Cal.) .. .Lt., U.S.N.R. 

Tolliver, H. A., (Iharles City (APO 91, New York, N. Y.) 

Capt., A.U.S. 

Franklin County 

Byers, W. L., Sheffield (Jefferson Barracks, Mo.) 1st Lt.. A.U.S. 

Hedgecock, L. E., Hampton (Camp Lejeune, 

N. Car.) Lt. Comdr., U.S.N.R. 

Randall, W. L., Hampton (Oceanside, Cal.) Lt., U.S.N.R. 

Walton, S. G.. Hampton (APO New York, N. Y.) . . .Capt., A.U.S. 

Fremont County 

Kerr, W. H.. Hamburg (Camp Phillips, Kan.) Capt., A.U.S. 

Marrs, W. D., Tabor (Ardmore. Okla.) Capt., A.U.S. 

Powell. R. A., Farragut (Great Lakes, Ill.)...Lt. (jg) , U.S.N.R. 

Wanamaker, A. R., Hamburg (APO 939, Seattle, 

Wash.) Capt., A.U.S. 

Greene County 

Cartwright, F. P„ Grand Junction (APO 511, New York. 

N. Y.) Capt., A.U.S. 

Castles, W. A., Rippey (APO 958, San Francisco, Cal.) 

Major, A.U.S. 

Hanson. L. C., Jefferson (APO 728, New York, N. Y.) 
Capt., A.U.S. 

Jongewaard, A. J., Jefferson (Fleet PO, San 

Francisco, Cal.) Lt. Comdr., U.S.N.R. 

Limburg, J. I.. Jr., Jefferson (APO 603, San Francisco, 

Cal.) Major, A.U.S. 

Lohr, P. E., Churdan (Hastings, Nebr.) Lt., U.S.N.R. 

Grundy County 

Cullison, R. M., Dike (Fort Howard, Md.) Major, A.U.S. 

Rose, J. E., Grundy Center (Fleet PO, New York, 

N. Y.) Lt. Comdr., U.S.N.R. 

Hnniiltun County 

*Buxton O. C., Webster City (APO 9921, New York, 

N. y.) 1st Lt.. A.U.S. 

Howar, B. F.. Jewell (APO 514, New York, N. Y.) Major, A.U.S. 

James, D. W., Kamrar (APO 370, New York, N. Y.) 

Capt., A.U.S. 

Lewis, W. B., Webster City (APO 383, New York, 

N. Y.) Major. A.U.S. 

Mooney, F. P., Jewell (London, England) Capt., R.A.M.C. 

Paschal, G. A., Williams (Camp Barkeley, Texas) . .Capt., A.U.S. 

Patterson, R. A., Webster City (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

Ptacek, J. L.. Webster City (APO 12846 G, New York, 

N. Y.) Capt., A.U.S. 

Schrader, M. A., Webster City (Topeka, Kan.).... 1st Lt., A.U.S. 

Thompson, E. D., Webster City (Biloxi. Miss.) Capt., A.U.S. 

Hancock- VVInnehngo Counties 

Dolmage, G. H., Buffalo Center (Denver, Colo.) Capt., A.U.S. 

Dulmes, A. H., Klemme (APO 782, New York, 

N. Y.) Capt., A.U.S. 

Eller, L. W„ Kanawha (APO 302, New York, 

N. Y.) Capt., A.U.S. 

Irish, T. J., Forest City (Fleet PO, San Fran- 
cisco. Cal.) Lt. Comdr., U.S.N.R. 

Shaw, D. F„ Britt (Delhart, Tex.) Major, A.U.S. 

Thomas. C. W., Forest City (Camp Crowder, Mo.) . .Capt., A-U.S. 

Hardin County 

Burgess, A. W., Iowa Falls (Jacksonville, Fla.) Lt.. U.S.N.R. 

Houlihan, F. W., Ackley (APO 860, New York, 

N. Y.) 1st Lt., A.U.S. 

Jansonius, J. W., Eldora (APO 4834, New York, 

N. Y.) Capt., A.U.S. 

Johnson, R. J., Iowa Falls (APO 514, New York, 

N. Y.) Capt, A.U.S. 

Johnson. W. A., Alden (Orlando, Fla.) Capt., A.U.S. 

Shurts, J. J., Eldora (Camp Roberts, Cal.) 1st Lt., A.U.S. 

Steenrod, E. J., Iowa Falls (Fleet PO, San Francisco, 

Cal.) Lt.. U.S.N.R. 

Todd, V. S., Eldora (APO 9641, San Francisco, Cal.) Capt., A.U.S. 

Hnrrisnn County 

Bergstrom. A. C., Missouri Valley (Ft. Ord, Cal.) ... Capt., A.U.S. 

Burbridge, G. E., Logan (APO 611, New York, 

N. Y.) Major. A.U.S. 

Byrnes. C. W., Dunlap (APO 980, Seattle, Wash.) . .Capt., A.U.S. 

Heise, C. A., Jr„ Missouri Valley (Fleet PO, San 

Francisco, Cal.) Lt„ U.S.N.R. 

Tamisiea, F. X., Missouri Valley (APO 662, New York, 

N. Y.) Capt., A.U.S. 

Henry County 

Brown, W. B., Mount Pleasant (APO 571, New York. 

N. Y.) Major, A.U.3. 


VoL. XXXV, No. 3 


Journal of Iowa State AIedical Society 


105 


Dwankowski, Carl, Mt. Pleasant (APO 511, 

New York, N. Y.) Capt., A.U.S. 

Gloeckler, B. B., Mount Pleasant (APO 9768. New York, 

N. Y.) Capt., A.U.S. 

Hartlej', B. D., Mount Pleasant (APO 17130, New 

York, N. Y.) Capt., A.U.S. 

Megorden, W. H., Mount Pleasant (Ogden, Utah) .. Capt., A.U.S. 

Ristine, L. P., Mount Pleasant (APO 9648, New York, 

N. Y.) Major, A.U.S. 

Howard Countv 

Buresh, Abner, Lime Springs (Fleet PO, San Francisco, 

Cal.) ; Lt.,U.S.N.R. 

Nierling, P. ^., Cresco (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Humboldt County 

Arent, A. S.. Humboldt (Stockton, Cal.) Capt., A.U.S. 

Coddington, J. H., Humboldt (Oklahoma City. Okla.) .Capt., A.U.S. 

Ida County 

Dressier, J. B., Ida Grove (APO 713, Unit 2, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Martin, J. W., Holstein (Seymour. Ind.) Capt., A.U.S. 

Iowa County 

Geiger, U. S., North English (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

McDaniel, J. D., Marengo (Fort Ord. Cal.) Capt., A.U.S. 

Miller. D. F., Williamsburg (Fleet PO. San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

Jackson County 

Bausch, R. G., Bellevue (APO 251, New York, 

N. Y.) Capt., A.U.S. 

Skelley, P. B., Jr., Maquoketa (Ft. Lewis, Wash.) . .1st Lt., A.U.S. 

Swift. F. J., Jr., Maquoketa (APO 652, New York, 

N. Y.) Major, A.U.S. 

Jasper County 

Doake, Clarke, Newton 1st Lt., A.U.S. 

Minkel. R. M., Newton (APO New York, N. Y.) . Major, A.U.S. 

Ritchey, S. J., Newton Lt. Col., A.U.S. 

Jefferson County 

Castell, J. W., Fairfield (APO 9907, New York, 

N. Y.) Capt., A.U.S. 

Frey, Harry, Fairfield (Norfolk, Va.) Lt. Comdr., U.S.N.R. 

Gittler, Ludwig, Fairfield Lt. Col.. A.U.S. 

Graber, H. E., Fairfield Galesburg, 111 Major, A.U.S. 

Taylor. I. C., Fairfield (Washington, D. C.) 1st Lt., A.U.S. 

Johnson County 

Agnew, J. W., Iowa City (APO 17604, New York 
N. Y.) Capt., A.U.S. 

Albert, S. M., Iowa City (Camp White, Ore.) 1st Lt., A.U.S. 

Allen, J. H., Iowa City (Scott Field, 111.) Major, A.U.S. 

Anderson, E. N., Iowa City (APO 647, New York, 

N. Y.) Major, A.U.S. 

Boyd, E. J., Iowa City (APO 140, New York, N. Y.) .Capt., A.U.S. 

Brinkhous, K. M., Iowa City (APO 4672, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Bunge, R. G., Iowa City (Biloxi, Miss.) 1st Lt.. A.U.S. 

Callahan. G. D.. Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Cobum, F. E„ Iowa City (Toronto, Canada) Capt., R.C.A. 

Cooper, W. K„ Iowa City (Mitchell Field, N. Y.) . . . .Capt., A.U.S. 

Crowell, E. A., Iowa City (Ft. Geo. Wright. Wash.) .Capt., A.U.S. 

Diddle, A. W., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Dorner, R. A., Iowa City (APO 534, New York. 

N. Y.) Capt., A.U.S. 

Elmquist, H. S., Iowa City (San Diego, Cal.) .Lt. Comdr., U.S.N.R. 

Emmons, M. B., Iowa City (Abilene, Texas) Capt., A.U.S. 

Flax, Ellis, Iowa City (APO 6833, New York. N. Y.) 1st Lt., A.U.S. 

Flynn, J. E., Iowa City (Hot Springs, Ark.) Major, A.U.S. 

Fourt, A. S., Iowa City (APO 34, New York, 

N. Y.) Lt. Col.. A.U.S. 

Francis, N. L., Iowa City (Annapolis, Md.)....Lt. (jg), U.S.N.R. 

Galinsky, L. J., Oakdale (Camp Crowder, Mo.) Capt., A.U.S. 

Garlinghouse, R. O., Iowa City (Ft. Riley. Kan.) . .Lt. Col., A.U.S. 

Hardin, R. C., Iowa City (APO 608, New York, 

N. Y.) Major, A.U.S. 

Hartung, Walter, Iowa City (Camp Carson, Colo.) . .Capt., A.U.S. 

Hessin, A. L., Iowa City (APO 452, New York, 

N. Y.) Major, A.U.S. 

Irwin, R. L., Iowa City (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

January, L. E„ Iowa City (Pyote, Texas) Major, A.U.S. 

Kanealy, J. F., Iowa City (APO 928, San Francisco, 

Cal.) ; 1st LL, A.U.S. 

Keislar, H. D., Iowa City (Washington, D. C.) 1st Lt., A.U.S. 

Lage, R. H., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. U.S.N.R. 

Laubscher, J. H., Iowa City (Ft. Benning, Ga.). . . .1st Lt., A.U.S. 

Longwell, F. H., Iowa City (Daytona. Fla.) Major, A.U.S. 

Moreland. F. B., Iowa City (Maxwell Field, Ala.) .. 1st Lt., A.U.S. 

Nagyfy, S. F., Iowa City (Fleet PO, New York, 

N. Y.) Lt„ U.S.N.R. 

Newman, R. W., Iowa City (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Parkin, G. L., Iowa City (Mountain Home, Idaho) 1st Lt., A.U.S. 

Paulus. E. W., Iowa City (APO 34, New York, 

N. Y.) Lt. Col., A.U.S. 

Petersen, V. W., Iowa City (APO 689, New York, 

N. Y.) Col., A.U.S. 

Sells, R. L., Jr., Iowa City (Palmdale, Cal.) Capt., A.U.S. 

Smith. H. F„ Iowa City (New York. N. Y.) Lt. Comdr., U.S.N.R. 

Springer, E. W., Iowa City (APO 678, New York, 

N. Y.) Capt., A.U.S. 


Stadler, H. E., Iowa City (Washington. D. C.) .... 1st Lt., A.U.S. 
Staggs. W. A., Iowa City (Camp Robinson, Ark.) . .Major, A.U.S. 

Stephens, R. L., Iowa City (Orlando, Fla.) Capt., A.U.S. 

Stump. R. B., Iowa City (Denver, Colo.) Capt.. A.U.S. 

Titus, E. L., Iowa City (Belmont, Mass.) Col., A.U.S. 

Trapasso. T. J., Iowa City (APO 520, New York, 

N. Y. ) Capt. A.U.S. 

Trussell, R. E., Iowa City (APO 5467, San Francisco, 

Cal.) Capt., A.U.S. 

Vest, W. M., Iowa City (Menlo Park, Cal.) Capt., A.U.S. 

Ward, R. H., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Weatherly, H. E., Iowa City (APO 72, San Francisco, 

Cal.) Capt., A.U.S. 

Wollmann, W. W., Iowa City (Staunton, Va.) 1st Lt., A.U.S. 

Ziffren, S. E., Iowa City (Springfield Mo.) 1st Lt.. A.U.S. 

.Junior Members 

Adams, M. P., Iowa City Lt. (jg), U.S.N.R. 

Ahrens. J. H., Iowa City (APO San Francisco, Cal.) ... .A.U.S. 

Ball, A. L.. Iowa City (Camp Polk, La.) Major, A.U.S. 

Barrent, M. E., Iowa City (Camp Tyson, Tenn.) . .Capt., A.U.S. 
Black, N. M., Iowa City (McChord Field, Wash.) 1st Lt., A.U.S. 
Blair, J. D., Iowa City (APO San Francisco, Cal.) .Major, A.U.S. 

Boyd. R. J.. Iowa City (Spokane, Wash.) Capt., A.U.S. 

Brintnall, E. S., Iowa City (Colorado Springs, 

Colo.) 1st Lt., A.U.S. 

Burr, S. P., Iowa City (APO San Francisco, Cal.) .1st Lt., A.U.S. 
Carney, R. G., Iowa City (Fleet PO, San Francisco. 

Cal.) Lt.. U.S.N.R. 

Connole, J. F., Iowa City (Camp Bowie, Texas) .. 1st Lt., A.U.S. 
Couch. O. A.. Iowa City (Camp Van Dorn, Miss.) . .1st Lt., A.U.S. 
Coulson, F. H., Iowa City (APO New York, N. Y.) . .Capt., A.U.S. 
Decker, C. E., Iowa City (Oklahoma City, Okla.) .. 1st Lt., A.U.S. 
Donnelly, B. A., Iowa City (APO San Francisco, 

Cal.) 1st Lt., A.U.S 

Ehrenhaft, J. L., Iowa City (APO New York, 

N. Y.) 1st Lt., A.U.S. 

Englerth, F. L., Iowa City (APO San Francisco, 

Cal.) Capt., A.U.S. 

Freiberg, M., Iowa City (Jefferson Barracks, Mo.) A.U.S. 

Classman, A. L., Iowa City (Palm Springs, Cal.) 1st Lt., A.U.S. 

Hamilton, H. E., Iowa City (Chicago, 111.) 1st Lt., A.U.S. 

Harms, G. E., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Hendricks, A. B„ Iowa City (Klamath Falls, Ore.) . . .Lt., U.S.N. 
Hovis, Wm., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. (jg), U.S.N.R. 

Ide, L. W.. Iowa City (Fort Warren, Wyo.) 1st Lt., A.U.S. 

Jacobs, C. A., Iowa City (APO New York, N. Y.) Major, A.U.S. 
Kaplan, Nathan, Iowa City (Carlisle Bar- 
racks, Pa.) 1st Lt,, A.U.S. 

Keil. P. G., Iowa City (Sioux City, Iowa) 1st Lt., A.U.S. 

Kelberg, M. R., Iowa City (Alameda, Cal.) Lt., U.S.N.R. 

Keleher, M. F., Iowa City (Great Lakes, Ill.),.Lt. (jg), U.S.N.R. 

Keohen, G. F., Iowa City (Camp Grant, 111.) Capt., A.U.S. 

Kugler, F. E., Iowa City (Fort Warren. Wyo.) Capt., A.U.S. 

Lowry, F. C., Iowa City (Sioux Falls, S. D.) 1st Lt., A.U.S. 

McCann, J. P., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

McQuiston, W. 0., Iowa City (APO San Francisco, 

Cal.) Capt., A.U.S. 

Moen, B. H., Iowa City 

Moon, R. E., Iowa City (APO New York, N. Y.)..lstLt., A.U.S. 

Odell, Lester, Iowa City (Pensacola, Fla.) Lt. (jg), U.S.N.R. 

Phillips, R. M., Iowa City (San Francisco, Cal.) .. 1st Lt., A.U.S. 

Pulliam, R. L., Iowa City (APO 350, New York, 

N. Y.) Major, A.U.S. 

Randall, C. G., Iowa City 

Randall, R. G., Iowa City (Waterloo, Iowa) Capt., A.U.S. 

Rosenbusch, M., Iowa City (Fort Leonard Wood, 

Mo.) 1st Lt., A.U.S. 

Russin, L. A., Iowa City (Fort Blanding, Fla.) Capt., A.U.S. 

Saar, J. L., Iowa City (APO New York, N. Y.) .. .Capt., A.U.S. 

Sawtelle, W. W., Iowa City Lt., U.S.N.R. 

Schwidde, J. T., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Shand, J. A., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Shapiro, S. I., Iowa City 

Simpson, F. E., Iowa City (Camp Grant, 111.) A.U.S. 

Skewis, J. E., Iowa City (Corona, Cal.) Lt., U.S.N.R. 

Skouge, O. T., Iowa City 

Towle. R. A., Iowa City (Fleet PO, San Francisco. 

Cal.) Lt. Comdr., U.S.N.R. 

Warren, R. F., Iowa City (Santa Barbara, Cal.) A.U.S. 

Watters, V. G., Iowa City (Fort Leonard Wood, 

Mo.) 1st Lt., A.U.S. 

Wicks, W. J., Iowa City (Camp Crowder, Mo.) Capt., A.U.S. 

Williams, L. A., Iowa City (Treasure Island, Cal.) .1st Lt., A.U.S. 

Willumsen, H. C., Iowa City (Denver, Colo.) Capt., A.U.S. 

Wolkin, J., Iowa City (San Antonio, Texas) Capt., A.U.S. 

Yetter, W. L., Iowa City (APO New York, N. Y.)..Capt., A.U.S. 

Zahrt, N. E., Iowa City (Keesler Field, Miss.) Capt., A.U.S. 

Zimmerman, H. A., Iowa City (Santa Ana, Cal.) . .1st Lt.. A.U.S. 
Keokuk County 

Bjork. Floyd, Keota (APO 254, New York, N. Y.) . .Capt., A.U.S. 

Doyle, J. L., Sigourney (Camp Berkeley, Texas) A.U.S. 

Engelmann, A. T., What Cheer (Camp Polk, La.) . .Capt., A.U.S. 

Graham, J. A., Gibson (Needles. Cal.) 1st Lt., A.U.S. 

Montgomery, G. E., Keota (Antioch, Cal.) Capt., A.U.S. 

Wiley. Dudley, Hedrick (Mason City. Wash.) 

Kossuth County 

Clapsaddle, D. W.. Burt (Denver, Colo.) Capt., A.U.S. 

Corbin, R. L.. Luverne (Des Moines. Iowa) Capt., A.U.S. 


106 


Journal of Iowa State IMedicai, Society 


March, 1945 


Kenefick, J. N., Alprona (Fle«t PO, San Francisco, 

Cal.) Lt. Conidr., U.S.N.R. 

Williams, R. L., Lakota (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R 

Lee County 

Ashline, G. H., Keokuk (APO 253, New York, N. Y.) Capt., A.U.S. 

Cleary. H. G.. Fort Madison (I'T. Bennine, Ga. ) 

Capt., A.U.S. 

Cooper, R. E., Keokuk (APO 665, San Francisco, Cal.) Capt. A.U.S. 

.Johnstone. A. A., Keokuk (APO 942, Seattle, Wash.) .Col., A.U.S 

McKee, T. L., Keokuk (Miami Beach, Fla.) Major, A.U.S. 

Pumphrey, L. C.. Keokuk (Ft. Leonard Wood, Mo.). Major, A.U.S. 

Rankin, J. R., Keokuk (Memphis, Tenn.) Lt., U.S.N.R. 

Richmond, A. C., Fort Madison (Treasure Island. 

Cal.) Lt. Comdr., U.S.N.R. 

Steffey, F. L., Keokuk (Fort Snelling, Minn.) 

Van Werden, B. D., Keokuk (APO 4777, New York, 

N. Y.) Capt., A.U.S. 

Younan, Thomas, Ft. Madison (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Linn County 

Andre, G. R., Lisbon (APO 90, New York, N. Y.) . .Lt. Col., A.U.S. 

Berney, P. W.. Cedar Rapids (APO 207, New York, N. 

Y.) .Capt., A.U.S. 

Block, W. M., Cedar Rapids (APO 926, San Francisco, 

Cal.) Capt., A.U.S. 

Chapman, R. M„ Cedar Rapids (Chicago, 111.) Capt., A.U.S. 

Coughlan, V. H., Coggon (Fort Snelling, Minn.) A.U.S. 

Courier, W. O., Springville (APO 464, New York, 

N. Y.) Major, A.U.S. 

Downing, J. S., Cedar Rapids (APO 665, San Fraijcisco, 

Cal.) Lt. Col.. A.U.S. 

Dunn, F. C., Cedar Rapids (Winfield, Kan.) Major, A.U.S. 

Gearhart, Merriam, Springville (APO 204, New York, 

N. Y.) Major, A.U.S. 

Gerstman, Herbert, Marion (APO 862, New York, 

N. Y.) Capt., A.U.S. 

Halpin, L. J., Cedar Rapids (APO 17928, San Francisco, 

Cal Major, A.U.S. 

Hecker, J. T., Cedar Rapids (Camp Bowie, Texas) .. Capt., A.U.S. 

Jirsa, H. O., Cedar Rapids (APO 871, New York, 

N. Y.) Lt. Col., A.U.S. 

Keith, J. J., Marion (Menlo Park, Cal.) Major, A.U.S. 

Kieck, E. G., Cedar Rapids (San Diego, Cal.) .Lt. Comdr., U.S.N.R. 

Kruckenberg, W. G., Mount Vernon (Fleet PO, San 

Francisco, Cal.) Lt., U.S.N.R. 

Leedham, C. L.. Springville (Camp Campbell, Ky.)...Col., A.U.S. 

Locher, R. C., Cedar Rapids (APO 18085, New York, 

N. Y.) Major, A.U.S. 

Locher, R. C., Cedar Rapids (Camp Gruber, Okla.) . Major, A.U.S. 

tMacDougal, R. F., Cedar Rapids (APO 9067, New York, 

N. Y.) Capt., A.U.S. 

McConkie, E. B., Cedar Rapids (Hines, 111.) Major, A.U.S. 

McQuiston, J. S., Cedar Rapids (Fort Warren, 

Wyo.) Lt. Col., A.U.S. 

Meflert, C. B., Cedar Rapids (APO 403, New York, 

N. Y.) Lt. Col.. A.U.S. 

Murray, E. S., Cedar Rapids (APO 787, New York, . 

N. Y.) Major, A.U.S. 

Netolicky, R. Y., Cedar Rapids (Hawthorne, 

Nev.) Lt. Comdr., U.S.N.R. 

Noble, W. C., Cedar Rapids (Camp San Luis Obispo, 

Cal.) 1st Lt., A.U.S. 

Noe. C. A., Cedar Rapids (Hot Springs, Ark.) Major. A.U.S. 

Parke. John, Cedar Rapids Major, A.U.S. 

Proctor, R. D., Cedar Rapids (Fleet PO, San Fran- 
cisco, Cal.) Comdr., U.S.N.R. 

Redmond, J. J., Cedar Rapids (APO 813, New York, 

N. Y.) Major, A.U.S. 

Rieniets, J. H., Cedar Rapids, (Charleston, S. 

Car.) Lt. Comdr., U.S.N.R. 

Sedlacek, L. B., Cedar Rapids (APO 244, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Smrha, J. A., Cedar Rapids (Topeka, Kan.) Capt., A.U.S. 

Stansbury, J. R., Cedar Rapids (Fort Lewis, 

Wash.) Capt., A.U.S. 

Stark, C. H., Cedar Rapids (Denver, Colo.) Capt., A.U.S. 

Sulek. A. E.. Cedar Rapids (APO 244, San Fran- 
cisco, Cal.) Major, A.U.S. 

Woodhouse, K. W., Cedar Rapids (APO 619, New York, 

N. Y.) Lt. Col., A.U.S. 

Wray, R. M., Cedar Rapids (APO 958, San Francisco, 

Cal.) Major, A.U.S. 

Yavorsky, W. D., Cedar Rapids (Jacksonville, Fla.) 

Lt. Comdr., U.S.N. 

Louisa County 

DeYarman, K. T., Morning Sun (San Antonio, 

Texas) Capt., A.U.S. 

Tandy, R. W., Morning Sun (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Luen.s County 

Lister, K. E., Chariton (Fort Snelling. Minn.) A.U.S. 

Lyon County 

Cook, S. H., Rock Rapids (Memphis, Tenn.) Major, A.U.S. 

JCorcoran, T. E., Rock Rapids (Am. P.O.W. 3040, Oflag 64, 
Germany) Capt., A.U.S. 

Moriarty, J. F., Rock Rapids (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Madison County 

Boden, H. N.. Truro (Fresno, Cal.) 

Chesnut, P. F., Winterset (Camp Gruber, Okla.) Capt., A.U.S. 

Veltman, J. F., Winterset (APO 967, San Francisco, 

Cal.) Capt., A.U.S. 


Wicks. R. L., Winterset (APO 637, New York, N. Y.) 

.Lt. Col., A.U.S. 

Mahaska County 

Bennett, G. W.. Oskaloosa (APO 9641, San Francisco, 

Cal.) . Major. A.U.S. 

Bos, H. C.. Oskaloosa Major, A.U.S. 

Campbell, W. V., Oskaloosa (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Clark. G. H.. Oskaloosa (Mare Island. Cal.) . .Lt. Comdr., U.S.N.R. 

Greenlee, M. R., Oskaloosa (Port Hueneme, 

Cal.) Lt. Comdr., U. S.N.R. 

Lemon, K. M.. Oskaloosa (APO 637, New York, 

N. Y.) Capt., A.U.S. 

Zager, L. L., Oskaloosa (APO 436, New York, 

N. Y.) Capt., A.U.S. 

Marion County 

Elliott, V. J., Knoxville (APO 558, New York, 

N. Y.) Major, A.U.S. 

Mater, D. A., Knoxville (Lincoln, Neb.) Major, A.U.S. 

Ralston, F. P., Knoxville (Indio, Cal.) Capt., A.U.S. 

Schiek. C. M., Knoxville Lt. Comdr., U.S.N.R. 

Schroeder, M. C., Pella (Canip Livingston, La.) .... Capt., A.U.S. 

Williams, D. B., Knoxville .Capt., A.U.S. 

Marshall County 

Carpenter, R. C., Marshalltown (APO 678 New York, 

N. Y.) Capt., A.U.S. 

Marble, E. J., Marshalltown (Fleet PO, Can Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Marble, W. P., Marshalltown (Colorado Springs, 

Colo.) Major, A.U.S. 

Meyer, M. G., Marshalltown (APO 513, New York, 

N. Y.) Major, A.U.S. 

Noonan, J. J., Marshalltown (Fort Jackson, 

S. Car.) Lt. Col., A.U.S. 

Phelps, R, E., State Center (APO 7, San Francisco. 

Cal.) Capt., A II. S. 

Sinning, J. E., Melbourne (Rochester, Minn.) Capt., A.U.S. 

Smith, E. M., State Center (APO 520, New York, 

N. Y.) Lt. Col., A.U.S. 

Stegman, J. J., Marshalltown (AP*^ 620, New York, 

N. Y.) Major, A.U.S. 

Wells, R. C., Marshalltown (Gowen Field, Idaho) . . . .Capt., A.U.S. 

Wolfe, O. D., Marshalltown (APO 937, Seattle 
Wash.) . .Capt., A.U.S. 

Wolfe. R. M., Marshalltown IFleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Mills County 

DeYoung, W. A., Glenwood (APO 228, New York, 

N. Y.) Capt, A.U.S. 

Kuitert, J. H., Glenwood ( St. Cloud, Minn.) ........ Major, A.U.S. 

Magaret, E. C., Glenwood (APO 973, Minneapolis, 

Minn.) Capt, A.U.S. 

Shonka, T. E., Malvern' (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Mitchell County 

Culbertson, R. A., St. Ansgar (APO 957, San 

Francisco, Cal.) Lt. Col., A.U.S. 

Moore. E. E., Osage (APO 591. New York, N. Y.) . Major, A.U.S. 

Owen, W. E., Osage (Fleet PO. San Francisco, Cal.) 

Lt (jg), U.S.N.R. 

Walker, T. G., Riceville (Fleet PO. New York, 

N. Y.) Lt. U.S.N.R. 

Mononn County 

Aimer, L. E., Moorhead (Fort Knox, Ky.) Capt, A.U.S. 

Anderson, S. N., Onawa (Great Lakes, 111.) Lt., U.S.N.R. 

Ganzhorn, H. L., Mapleton (APO 72, San Francisco, 

Cal.) Capt. A.U.S. 

Gaukel, L. A., Onawa (Fort Riley, Kan.).... Capt., A.U.S. 

tHarlan, M. E., Onawa (Fleet PO, San Francisco, 

Cal.) Lt (jg), U.S.N.R. 

Stauch, M. O., Whiting (Fort Lewis, Wash.) Major, A.U.S. 

Wainwright, M. T., Mapleton (Hines, 111.) Capt., A.U.S. 

Wolpert, P. L., Onawa (Camp Atterbury, Ind.) .... Capt, A.U.S. 

Monroe County 

Gilliland, C. H., Albia (Fleet PO, San Francisco, Cal.) .Lt., U.S.N. 

Heimann, V. R., Albia (Camp Maxey, Texas) Capt, A.U.S- 

Richter, H. J., Albia (Waco, Texas) Major, A.U.S. 

Smith, R. A., Albia (New Cumberland, Pa.) Capt., A.U.S. 

Montgomery County 

Bastron, H. C., Red Oak (APO 951, San Francisco, 

Cal.) - Major. A.U.S. 

Hansen, F. A., Red Oak (Clarksville, Ark.) Lt., U.S.N.R. 

Nelson, C. C., Red Oak (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Panzer, E. J. C„ Stanton (Fleet PO, San Francisco, 

Cal.^ Lt (jg), U.S.N.R. 

Rost, G. S., Red Oak (Halstead, Kan.) Capt., A.U.S. 

Sorensen, E. M., Red Oak (Jefferson Barracks, 

Mo.) Capt., A.U.S. 

Muscatine County 

Ady, A. E., West Liberty (Pensacola, Fla.) Comdr., U.S.N.R. 

Asthalter, R. W., Muscatine (Fort Meade, Md.) ... 1st Lt., A.U.S. 

Carlson. E. H., Muscatine (Milwaukee, Wis.) Capt, A.U.S. 

Goad, R. R., Muscatine (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

Kimball, J. E., Jr., West Liberty (Sioux City, Iowa) .Major, A.U.S. 

Lindley, E. L., Muscatine (APO 6, San Francisco, 

Cal.) Capt., A.U.S. 

Muhs. E. O., Muscatine (APO 678, New York, 

N. Y. ) Major, A.U.S. 

Norem, Walter. Muscatine (APO, Miami, Fla.) Capt, A.U.S. 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Societ'i' 


107 


Robertson. T. A., West Liberty (APO 119, New York, 

N. Y.) Capt., A.U.S. 

Sywassink, G. A„ Muscatine (APO 488-“Y” 

Forces, New York, N. Y.) Lt. Col., A.U.S. 

Whitmer, L. H.. Wilton Junction (Fort Sill, 

Okla.) Lt. Col., A.U.S. 

O’Brien County 

Getty, E. B., Primghar (APO 739, New York, 

N. Y.) 

Hayne, W. W„ Paullina (APO 638, New York, 

N. Y.) 

Moen, S. T„ Hartley (APO 689, New York, 

N. Y.) 

Myers. K. W., Sheldon (Watertown. S. Dak.). 

Osceola Oonnty 
Kuntz, G. S., Sibley (APO 34, New York, N. Y.) . . . .Capt., A.U.S. 


.Capt., A.U.S. 

. Capt., A.U.S. 

.Major, A.U.S. 
1st Lt., A.U.S. 


Pagre County » 

Barnes. C. A., Shenandoah (Fort Bragg. N. C.) ... .Capt., A.U.S. 
Blackman, Nathan, Clarinda (Ft. Leavenworth, 

Kan.) Capt., A.U.S. 

Bossingham, E. N., Clarinda (Fort Ord, Cal.) Major, A.U.S. 

Bunch, H. McK., Shenandoah (San Diego, 

Cal.) Lt. Comdr.. U.S.N.R 

Burdick. F. D., Shenandoah (Denver, Colo.) Capt., A.U.S. 

Burnett, F. K., Clarinda (APO 11336, New York, 

N. Y.) Major, A.U.S. 

Rausch, G. R., Clarinda (Sioux City, Iowa) Capt., A.U.S. 

Savage. L. W., Shenandoah (Fort Meade, Md.) .... 1st Lt.. A.U.S. 
Palo Alto County 

Davey, W. P., Emmetsburg (Fleet PO, San 
■ Francisco, Cal.) Lt., U.S.N.R. 

Plynioiitli County 

Bowers. C. V., LeMars (APO New York, N. Y.) .. 1st Lt., A.U.S. 

Fisch, R. J.. LeMars (Denver, Colo.) Capt., A.U.S. 

Foss, R. H., Remsen (Homestead, Fla.) Capt., A.U.S. 

Wolfson, Harold. Kingsley (Fort Lewis, Wash.) .... Capt., A.U.S. 


Pocahontas County 

Blair, F. L., Jr., Fonda (San Antonio. Texas) Lt., U.S.N.R. 

Herrick. T. G.. Gilmore City (APO 9876, New York, 

N. Y.) Capt., A.U.S. 

Larson, J. B., Laurens (APO 720, San Francisco, 

Cal.) Capt., A.U.S. 

Leserman, L. K., Rolfe (APO 602. San Francisco, 

Cal.) Capt., A.U.S. 

Patterson. A. W., Fonda (Des Moines, Iowa) Capt., A.U.S. 


Polk County 

Abbott, W. D., Des Moines (Fleet PO. San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Anderson, N. B., Des Moines (APO 667, New York, 

N. Y.) Lt. Col., A.U.S 

Angell, C. A., Des Moines (Ft. Bragg, N. Car.) ... .Capt., A.U.S. 

Anspach, R. S., Mitchellville (APO 528, New York, 

N. Y.) Lt. Col., A.U.S. 

Barner, J. L., Des Moines (Atlanta, Ga. ) Major, A.U.S. 

Barnes, B. C., Des Moines (Ogden, Utah) Major, A.U.S. 

Bates, M. T., Des Moines (Corona, Cal.) .... Lt. Comdr., U.S.N.R. 

Bender. H. R., Des Moines (Carlisle Barracks. 

Penn.) 1st Lt., A.U.S. 

Bond, T. A., Des Moines (Shoemaker, Cal.) Lt., U.S.N.R. 

Bone, H. C., Des Moines (Arlington, Cal.) Major, A.U.S. 

Brown, A. W., Des Moines (APO 6934, New York, 

N. Y.) Capt., A.U.S. 

Bruner. J. M., Des Moines (Camp Berkeley, Texas) . .Major, A.U.S. 

Bruns. P. D., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

IBurgeson, F. M., Des Moines (Gefangenennummer 1480, 
Lager-Bezeichnung : Kriegsgef-Offizierlager XXI B, 
Deutschland [Allemagne]) Capt., A.U.S. 

Caldwell, J. W., Des Moines, (Patricia Bay, 

British Columbia, Canada) Flight Lt., R.C. A. F. 

Chambers. J. W„ Des Moines (APO 648, New York, 

N. Y.) Capt., A.U.S. 

Chase. W. B., Jr., Des Moines (Fleet PO, San Francisco. 

Cal.) Lt., U.S.N.R. 

Clark. G. E., Jr., Des Moines (APO 520, New York, 

N. Y.) Capt., A.U.S. 

Connell. J. R., Des Moines (APO 507, New York, 

N. Y.) Major, A.U.S. 

Corn, H. IL, Des Moines (Camp Beale, Cal.) Capt., A.U.S. 

Goughian, D. W., Des Moines (APO 689, New York, 

N. Y.) Capt., A.U.S. 

Crowley, D. F., Jr., Des Moines (Presque Isle, Me.) . .Capt., A.U.S. 

Crowley, F. A., Des Moines (APO 783, New York, 

N. Y.) Capt., A.U.S. 

DeCicco, Ralph, Des Moines (APO 952, San Francisco, 

Cal.) Capt., A.U.S. 

Decker, H. G., Des Moines (Long Beach, 

Cal.) Lt. Comdr., U.S.N.R. 

Downing, A. H., Des Moines (Ft. Snelling, Minn. ). 1st Lt.. A.U.S. 

Dushkin, M. A., Des Moines (APO 689, New York, 

N. Y.) Lt. Col., A.U.S. 

Elliott, O. A., Des Moines (Pecos, Texas) Capt,, A.U,S. 

Ellis, H. G., Des Moines (APO 710, San Francisco, 

Cal.) Capt., A.U.S. 

Ervin, L. J„ Des Moines (Victoria, Texas) Lt. Col., A.U.S, 

Fleck, W, L,, Des Moines (Ft. Howard, Md.) Lt. Col., A.U.S. 

Fried, David. Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Fracasse, John, Des Moines 1st Lt., A.U.S. 


George, E. M., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Gerchek, E. W.. Des Moines 

Gibson, D. N., Des Moines (APO 322, Unit I, San 

Francisco, Cal.) Major, A.U.S. 

Glomset, D. A.. Des Moines (APO 9826 New York, 

N. Y.) Capt., A.U.S. 

Goldberg, Louie, Des Moines (APO 926, San Francisco, 

Cal.) Capt., A.U.S. 


Gordon, A. M., Des Moines (APO 600, New York, 

N. Y.) Capt., A.U.S. 

Graeber, F. O., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 


Greek. L. M., Des Moines (APO 512, New York, 


N. Y.) Capt., A.U.S. 

Gurau, H. H.. Des Moines (Malden, Mo.) Capt., A.U.S. 

Haines, D. J., Des Moines (APO 463, San Francisco, 

Cal.) Capt., A.U.S. 

Harris, D. D., Des Moines (Gulfport, Miss.) . .Lt. Comdr., U.S.N.R. 

Harris. H. L., Des Moines (Salina, Kan.) 1st Lt., A.U.S. 

Hess, John, Jr., Des Moines 1st Lt., A.U.S. 

James, A. D., Des Moines (Fort Eustis, Va.) .. .Comdr., U.S.N.R. 

.Johnston, C. H., Des Moines (Randolph Field, 

Texas) Lt. Col., A.U.S. 

Kast, D. H., Des Moines (Fort Stevens, Ore.) Capt.. A.U.S. 

Kelley, E. J., Des Moines (Columbus, Ohio) . .Lt. Comdr., U.S.N.R. 

Kelly. D H.. Des Moines (Denver, Colo.) Lt. Col.. A.U.S. 

Kirch, W. A. W., Des Moines (Astoria, Ore.) .Lt. Comdr., U.S.N.R. 

Klocksiem, H. L., Des Moines (APO New York, 

N. Y.) Capt., A.U.S. 

Kott.ke. E. E.. Des Moines (Temple, Texas) Capt., A.U.S. 

Landis, S. N., Des Moines (West Palm Beach, 

Fla.) 1st Lt., A.U.S. 

La Tona, Salvatore, Des Moines 1st Lt., A.U.S, 

Lederman, James. Des Moines 1st Lt., R.C. A. 

Lehman, E. W., Des Moines (APO 711, 

San Francisco. Cal.) Major, A.U.S. 

Losh, C. W., Jr., Des Moines (APO 209, New York, 

N. Y.) Capt., A.U.S. 

Lovejoy, E. P., Des Moines (Fleet PO, San Francisco, 


Maloney, P. J., Des Moines (Fort Lewis, Wash.) . . .1st Lt., A.U.S. 
Marquis, G. S., Des Moines (Brooklyn, N. Y. ) .Lt. Comdr., U.S.N.R. 

Martin, L. E., Des Moines (Helena, Ark.) 1st Lt., A.U.S. 

Matheson, J. H„ Des Moines (San Leandro, 

Cal.) Lt. Comdr., U.S.N.R. 

Mauritz, B. L., Des Moines (APO 763, New York, 

N. Y.) Capt., A.U.S. 

McCoy, H. J., Des Moines (Iowa City. Iowa) ... Comdr., U.S.N.R. 


McDonald, D. J., Des Moines (APO 339, New York, 


N. Y.) Major, A.U.S. 

McNamee, J. H., Des Moines (Fleet PO. San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Mencher, E. W., Des Moines 1st Lt., A.U.S. 

Merkel. B. M., Des Moines (APO 520, New York, 

N. Y.) Major, A.U.S. 

Montgomery, S. A., Des Moines (Carlisle Barracks, 

Pa.) Capt., A.U.S. 

Morden. R. P., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S 

Mumma, C. S., Des Moines (Los .Angeles, Cal.) .... Major, A.U.S. 

Murphy. J. H., Des Moines (Fleet PO, San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

Nelson. A. L.. Des Moines (Camp Livingston, La.) Major, A.U.S. 

Noun, L. J., Des Moines (Camp Peary, Va.) Lt., U.S.N.R. 

Noun, M. H., Des Moines (APO 228, New York, 

N. Y.) Major. A.U.S 

Nourse, M. H., Des Moines (Fleet PO, New York, 

N. Y.) Lt., U.S.N. 

Patton, B. W., Des Moines (Camp Robinson, 

Ark.) 1st Lt.. A.U.S. 

Pearlman, L. R., Des Moines (Battle Creek, Mich.) . .Major, A.U.S. 

Peisen. C. J., Des Moines (APO 165, New York, 

N. Y.) Capt., A.U.S. 

Penn, E. C., West Des Moines (APO 650, New York, 

N. Y.) Capt., A.U.S. 

Pfeiffer, E. P., Des Moines (APO 501, San Fran- 
cisco, Cal.) Capt.. A.U.S. 

Phillips. A. B., Des Moines (Corona. Cal.) Lt., U.S.N.R. 

Porter, R. J., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Powell. L. D., Des Moines (Oceanside, Cal.) Capt., U.S.N.R. 

Pratt, E. B., Des Moines (APO New York, N. Y.) . .Major, A.U.S. 

Priestley, J. B., Des Moines (Indiantown Gap, 

Penn.) Lt. Col., A.U.S. 

Purdy, W. O., Des Moines (APO 6935, New York, 

N. Y.) Capt., A.U.S. 

Riegelman, R. H., Des Moines (APO 559, New York, 

N. ■);.) Major, A.U.S. 

Robinson, V. C., Des Moines (Gulfport, Miss.) Major, A.U.S. 

Rotkow, M. J., Des Moines (Ft. Benj. Harrison, 

Ind.) Capt., A.U.S. 

Schaeferle, M. J., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Schlaser, V. L., Des Moines (Fleet PO, San Francsico, 

Cal.) Lt., U.S.N. 

Shepherd, L. K., Des Moines (APO New York, 

N. Y.) Major, A.U.S. 

Shiffler. H. K., Des Moines (APO 230, New York, 

N. Y.) Capt., A.U.S, 

Singer, P. L., Des Moines (Camp Grant, 111.) . . . . 1st Lt,, A.U,S. 

Skultety, J. A., Des Moines (New Orleans, La.) 

P. A. Surg., U.S.P.H.S. 


108 


Journal oi-' Towa State Medical Society 


March, 1945 


Smead, H. H., Des Moines (APO 141, New York, 

N. Y.) Capt., A.U.S. 

Smith, H. J., Des Moines (Chicago, 111.) Lt., U.S.N.R. 

Smith, R. T., Des Moines (APO 713, Unit I, San Francisco, 

Cal.) Capt., A.U.S. 

•Snodgrass, R. W.. Des Moines (APO 9528, New York, 

N. Y.) Capt., A.U.S. 

Snyder, G. E., Grimes (APO 264, San Francisco, 

Cal.) Major. A.U.S. 

Sohm, H. A., Des Moines Lt. Comdr., U.S.N.R. 

Sorensen, R. M., Des Moines (Topeka, Kan.) . .Major, U.S.P.H.S. 

Springer, F. A., Des Moines (Treasure Island, 

Cal.) Lt. Comdr., U.S.N.R. 

Stearns, A. B.. Des Moines (Denver. Colo.) Major, A.U.S. 

Stickler, Robert, Des Moines (APO New York, 

N. Y.) Major. A.U.S. 

Stitt, P. L., Des Moines (Seattle, Wash.) Lt. (jg) , U.S.N.R. 

Throckmorton, J. F., Des Moines (APO 339, New York, 

N. Y.) Major, A.U.S. 

Toubes. A. A., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Turner, H. V., Des Moines (Camp Fannin, Texas) . . .Capt., A.U.S. 

Updegraff, Thomas, Des Moines (Spokane, Wash.) . 1st Lt., A.U.S. 

Van Hale, L. A., Des Moines (APO 515, New York, 

N. Y.) ,..Capt., A.U.S. 

Vaubel. E. K., Des Moines (Washington, D. C.) ... .Capt., A.U.S. 

Wagner, E. C., Des Moines (Washington, D. C.) .. 1st Lt., A.U.S. 

Willett, W. M., Des Moines (APO 507, New York, 

N. Y.) Capt., A.U.S. 

Wirtz, D. C., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Zarchy, A. C.. Des Moines (Camp Cooke. Cal. )^. ... Capt., A.U.S. 

Pottawattamie County 


tBeaumont, F. H., Council Bluffs (APO 34, New York, 

N. Y.) Major, A.U.S. 

Collins, R. M., Council Bluffs (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Dean, A. M., Council Bluffs (Pensacola, Fla.) ... Comdr., U.S.N.R. 

Edwards, C. V., Council Bluffs (Pensacola, Fla.) 

Lt. Comdr., U.S.N.R. 

Floersch, E. B., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Hennessy, J. D., Council Bluffs (Shawnee, 

Okla.) Lt. Comdr, U.S.N.R. 

Jensen, A. L., Council Bluffs (Temple, Texas ).... Lt. Col., A.U.S. 

Klok, G. J., Council Bluffs (Fleet PO, San Diego, 

Cal.) Lt., U.S.N.R. 

Kurth, C. J., Council Bluffs (Camp Crowder, Mo.) . .Capt., A.U.S. 

Limbert, E. M., Council Bluffs (APO 403, New York, 

N. Y.) Major, A.U.S. 

Maiden, S. D., Council Bluffs (Camp Hood, Texas) . .Major, A.U.S. 

Martin, L. R., Council Bluffs (San Francisco, Cal.). .Capt., A.U.S. 

Mathiasen, H. W., Neola (Alexandria, La.) Capt., A.U.S. 

Moskovitz, J. M., Council Bluffs (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Rosenfeld, R. T., Council Bluffs (Staten Island, 

N. Y.) Capt., A.U.S. 

Standeven, W., Oakland (Colorado Springs, Colo.) . .Capt., A.U.S. 

Sternhill. Isaac, Council Bluffs (Springfield, Mo.) .. .Capt., A.U.S. 

Tinley, R. E., (bouncil Bluffs (APO 600, New York, 

N. Y.) Major, A.U.S. 

Treynor, J. V., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) ■.. .Comdr., U.S.N.R. 

West, A. G., Council Bluffs (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Wieseler, R. J., Avoca (McChord Field, Wash.) A.U.S. 

Wurl, O. A., Council Bluffs (APO 887, New York, 

N. Y.) Lt. Col., A.U.S. 

Poweshiek County 

Brobyn, T. E., Grinnell (Camp Swift, Texas) Major, A.U.S. 

Hickerson, L. C., Brooklyn (APO 551), New York, 

N. Y.) .Capt., A.U.S. 

Korfmacher, E. S., Grinnell (APO 92, San Francisco, 

Cal.) Capt., A.U.S. 

Niemann, T. V., Brooklyn (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Parish. J. R., Grinnell (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Somers, P. E., Grinnell (St. Louis, Mo.) 1st Lt., A.U.S. 

Ring-g-old County 

Seaman, C. L.. Mount Ayr (Fort Smith, Ark.) ... .Major, A.U.S. 

Sac County 

Bassett. G. H., Sac City ( Metairie, La.) Lt. Comdr., U.S.N.R. 

Deters, D. C., Schaller (APO 34, New York, N. Y Capt., A.U.S. 

Evans. W. I., Sac City (APO 9212, New York, 

N. Y.) Capt., A.U.S. 

Klocksiem, R. G., Odebolt (Oceanside, Cal.) Lt., U.S.N.R. 

Neu, H. N., Sac City (APO 708, San Francisco, 

Cal.) Lt. Col., A.U.S. 


Scott County 

tBaker, R. W., Davenport (APO 511, New York, 

N. Y.) Capt., A.U.S. 

Balzer, W. J., Davenport (APO 569, New York, 

N. Y.) Capt., A.U.S. 

Bishop. J. F., Davenport (Camp Wheeler, Ga.) .... Capt., A.U.S. 

Block, L. A.. Davenport (Cambridge, Ohio) Major, A.U.S. 

Boden, W. C., Davenport (APO 3760, New York, 

N. Y.) Capt., A.U.S. 

Boyer, U. S., Davenport (Rock Island, 111.) Lt. Col., A.U.S. 

Brown, M. J., Davenport (APO 562, New York, 

N. Y.) Major, A.U.S. 

Carey, E. T., Davenport (APO 928, San Francisco, 

Cal.) 1st Lt., A.U.S. 


Christiansen, C. C., Dixon (APO 961, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Coleman, Tom. Davenport (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Cummins, G. M., Jr., Davenport (Fort Custer, 

Mich.) Capt., A.U.S. 

Decker, C. E., Davenport (APO 321, San Francisco, 

Cal.) Major, A.U.S. 

Evans, H. J., Davenport (Daytona Beach, Fla.) .... Capt., A.U.S. 

Gibson, P. E., Davenport (Palm Springs, Cal.) .... Major, A.U.S. 

Goenne, Wm., Jr., Davenport (APO 91, New York, 

N. Y.) Capt., A.U.S. 

Hurevitz, H. M., Davenport (APO 370, New York, 

N. Y.) Major, A.U.S. 

Hurteau, Everett, Davenport (APO 647, New York, 

N. Y.) Capt., A.U.S. 

Hurteau, W. W., Davenport (Camp Barkeley, 

Texas) Major, A.U.S. 

Kimberly. L. W.. Davenport (Hines, HI.) Capt., A.U.S. 

Krakauer, Max, Davepf)ort (APO 655, New York, 

N. Y.) Capt., A.U.S. 

Kuhl, A. B., Jr., Davenport (Ft. Meade, Md.) 1st Lt., A.U.S. 

LaDage, L. H., Davenport (APO 229, New York, 

N. Y.) Major, A.U.S. 

Lorfeld. G. W.. Davenport (Columbus, Ohio) Capt., A.U.S. 

McMeans, T. W.. Davenport (APO 657, New York, 

N. Y.) Capt., A.U.S. 

Neufeld, R. J., Davenport (APO 565, Unit I, San Francisco, 

Cal.) Capt., A.U.S. 

Perkins, R. M., Davenport (APO 121B, New York, 

N. Y.) Capt., A.U.S. 

Sheeler, I. H., Davenport (APO 350, New York, 

N. Y.) Capt., A.U.S. 

Shorey, J. R., Davenport (APO 204, New York, 

N. Y.) Capt., A.U.S. 

Smazal, S. F., Davenport (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Sorenson, A. C., Davenport (Oakland, Cal.) ... Comdr., U.S.N.R. 

Sunderbruch, J. H., Davenport (APO 322, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Weinberg, H. B., Davenport (APO 72, San Francisco, 

Cal.) Major, A.U.S. 

Zukerman, C. M., Bettendorf (Chicago, III.) Capt., A.U.S. 


Shelby County 

Bisgard, C. V.. Harlan (Farragut, Idaho) . . .Lt. Comdr., U.S.N.R. 

Griffith, W. O., Shelby (APO 9490, New York, 

N. Y.) Capt., A.U.S. 

McGowan, J. P., Harlan (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Sioux County 

Gleysteen, R. R., Alton (Portsmouth. Va.)....Lt. Comdr., U.S.N. 

Grossmann, E. B., Orange City (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Larson, M. O., Hawarden (APO 562, New York, 

N. Y.) Lt. Col., A.U.S. 

Oelrich, A. M., Hull (APO New York, N. Y.) 1st Lt., A.U.S. 

Oelrich, C. D., Sioux Center (Buckley Field, Colo.) .1st Lt., A.U.S. 

Story County 

Conner, J. D., Nevada (APO 708, San Francisco, 

Cal.) CapL, A.U.S. 

Fellows, J. G., Ames (APO 451, New York, N. Y.) . .Major, A.U.S. 

Lekwa, A. H., Story City (San Diego, Cal.). .Lt. Comdr., U.S.N.R. 

McFarland. G. E., Jr., Ames (San Pedro, Cal.) .. .Lt., U.S.N.R. 

McFarland, J. E., Ames (Seattle, Wash.) . . . .Lt. Comdr., U.S.N.R. 

Rosebrook, L. E., Ames (APO 433, New York 
N. Y.) Major, A.U.S. 

Sperow, W. B., (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Thorburn, O. L., Ames (Clovis, N. Mex.) Major, A.U.S. 

Wall. David, Ames (Ft. Dix, N. J.) 1st LL, A.U.S. 

* Tama County 

Bezman. H. S.. Traer (APO 9875. New York, N. Y.) CapL, A.U.S. 

Boiler, G. C., Traer (Ft. Riley, Kansas) Capt., A.U.S. 

Dobias, S. G., Chelsea (APO 17928, San Francisco, 

Cal.) Capt., A.U.S. 

Havlik. A. J., Tama (San Diego. Cal.) Lt., U.S.N.R. 

Schaeferle, L. G., Gladbrook (APO New York, 

N. Y.) Capt., A.U.S. 

Standefer. J. M., Tama (Des Moines, Iowa) Lt., U.S.N.R. 

Taylor County 

Hardin. J. F., Bedford (APO 952, San Francisco, 

Cal.) 1st Lt., A.U.S. 

Union County 

Beatty, H. G., Creston (New Orleans, La.) 1st Lt., A.U.S. 

Paragas, M. R., Creston (APO 442, San Francisco, 

Cal.) Capt., A.U.S. 

Ryan, C. J.. Creston Capt., A.U.S. 

Wapello County 

Brentan, Emanuel, Ottumwa (APO 252, New York, 

N. Y.) 1st Lt., A.U.S. 

Brody, Sidney, Ottumwa Lt. Col., A.U.S. 

Gilfillan, C. D. N., Eldon (Battle Creek, Mich.) ... .Capt., A.U.S. 

Hughes,' R. O., Ottumwa (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Moore, G. C., Ottumwa (APO 17608, New York, 

N. Y.) Capt., A.U.S. 

Nelson. F. L., Jr.. Ottumwa (Springfield, Mo.) Capt., A.U.S. 

Prewitt, L. H., Ottumwa (Atlantic Clity, N. J.) Major, A.U.S. 

Selman, R. J., Ottumwa (El Paso, Texas) Col., A.U.S. 

Struble. G. C.. Ottumwa (Fort Harrison, Ind.) .LL Col., A.U.S. 

Whitehouse, 'W. N., Ottumwa (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


109 


Warren County 


Fullgrabe, E. A., Indianola (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Hoffman, G. R., Lacona (Camp San Louis Obispo, 

Cal.) Capt., A.U.S. 

Shaw, E. E.. Indianola (APO 834. New Orleans, 

La.) Capt.. A.U.S. 

Trueblood, C. A,, Indianola (APO 350, New Y^ork, 

N. Y.) Capt., A.U.S. 


Wnshinston County 

Boice, C. L., Washington (Fleet PO, San Francisco. 

Cal.) LC.U.S.N. 

Droz, A. K., Washington (Fleet PO. San Francisco, 

Cal.) Comdr., U.S.N.R. 

Mast, T. M., Washington (Long Beach. 

Cal.) Lt. Comdr.. U.S.N.R. 

Miller, J. R., Wellman (APO New York, N. Y.) . . . . 1st. Lt., A.U.S. 
Stutsman, R. E, Washington (Patuxent River, 

Md ) Lt., U.S.N.R. 

Ware, S. C., Kalona (APO 218, New York, N. Y.). .Capt., A.U.S. 
Wayne County 

Hyatt, C. N„ Jr., Humeston (APO 6, San Francisco, 

Cal.) Capt., A.U.S. 

Webster County 

Baker, C. J., Fort Dodge (APO New York, N. Y.) . .Major, A.U.S. 

Burch. E. S., Dayton (Palm Springs, Cal.) Capt., A.U.S. 

Burleson, M. W„ Fort Dodge (Pasadena, Cal.) Capt., A.U.S. 

Coughlan, C. H., Fort Dodge (Fort Des Moines, 

Iowa) Major, I..U.S. 

Dawson, E. B., Fort Dodge (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

Glesne, O. N., Ft. D^ge (New River, N. C.).Lt. Comdr., U.S.N.R. 

Joyner, N. M., Fort Dodge (Minneapolis, Minn.) A.U.S. 

Kluever, H. C., Fort Dodge (St. Louis, Mo.) 

Lt. Comdr., U.S.N.R. 

Larsen, H. T„ Fort Dodge (Pensacola, Fla.) Lt., U.S.N.R. 

Shrader, J. C., Fort Dodge (APO 758, New York, 

N. Y.) Lt. Col., A.U.S. 

fThatcher, O. D.. Fort Dodge (APO 634, New York, 

N. Y.) Capt,, A.U.S. 

Thatcher, W, C., Fort Dodge (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Van Patten, E. M., Ft. Dodge (El Paso, Texas) ... .Capt,, A.U.S. 


Winneshiek County 

Fritchen, A. F., Decorah (Mare Island, Cal.) . .Comdr., U.S.N.R, 

Hospodarsky, L. J., Ridgeway (APO 638, New York, 

NIY.) Lt. Col., A.U.S. 

Howard, W. H., Decorah Capt., A.U.S, 

Larson, L. E., Decorah (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Svendsen, R. N., Decorah (San Diego. Cal.)...Lt. (jg), U.S.N.R. 

Van Besien, G. J., Decorah (Springfield, Mo.) Capt., A.U.S. 

Woodbury County 

Bettler, P. L., Sioux City (APO 235, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Blackstone, M. A., Sioux City (Camp Stoneman, 

Cal.) Capt., A.U.S. 

Boe, Henry, Sioux City (Fort Snelling, Minn.) Capt., A.U.S. 

Burroughs, H. H., Sioux City (Fleet PO, San Fran- 
cisco, Cal.) \ Lt., U.S.N.R. 

JCmeyla, P. M., Sioux City (P.O.W., c/o Japanese 

Red Cross, Tokyo, Japan) Capt., A.U.S. 

Cowan, J. A., Sioux City (Oklahoma City, 

Okla.) Major, U.S.P.H.S. 

Crowder, R. E., Sioux City (Kansas City, 

Mo.) Lt. Comdr., U.S.N.R. 

Dimsdale, L. J., Sioux City (Clinton, Iowa) Capt., A.U.S. 

Down, H. I., Sioux City (APO 758, New York, 

N. Y.) Lt. Col., A.U.S. 

Elson, V. J., Danbury (APO 9875, New York, 

N. Y.) Capt., A.U.S. 

Frank, L. J., Sioux City (Fleet PO, San Francisco, 

Cal.) Comdr.. U.S.N.R. 

Graham, J. W., Sioux City (Pensacola, Fla.) Lt. Comdr., U.S.N.R. 

Grossman, M. D., Sioux City (APO 33, San Francisco, 

Cal.) Capt., A.U.S. 

Harris, D M., Sioux City (APO 444, New York, 

N. Y.) Capt., A.U.S. 

Heffeman, C. E., Sioux City (APO 17682, San 

Francisco, Cal.) Capt., A.U.S. 

Hicks, W. K., Sioux City (Spokane, Wash.) Major, A.U.S. 

Honke, E. M., Sioux City (Palm Springs, Cal.) Major, A.U.S. 

Kaplan, David, Sioux City (APO 36, New York. 

N. Y.) Capt., A.U.S. 

Knott, P. D., Sioux City (Camp Crowder, Mo.l Capt., A.U.S. 

Knott, R. C., Sioux City (APO 403, New York, 

N. Y.) Major, A.U.S. 

Krigsten, W. M., Sioux City (Springfield, Mo.) . . .Lt. Col., A.U.S. 

Lande, J. N., Sioux City (APO 63, New York, N. Y.) Major, A.U.S. 

Martin, R. F., Sioux City (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Mattice, L. H., Danbury (APO 713, San Francisco, 

Cal.) 1st Lt., A.U.S. 

McCuistion, H. M., Sioux City (APO 209, New York, 

N. Y.) Capt., A.U.S. 

Mugan, R. C., Sioux City (Miami Beach. Fla.) Capt., A.U.S. 

Osincup, P. W„ Sioux City (APO 520, New York, 

N. Y.) Capt., A.U.S. 

Rarick, I. H., Sioux City (Camp Pinedale, Cal.) .... Capt., A.U.S. 

Reeder, J. E., Jr.. Sioux City (APO 209, New York, 

N. Y.) Capt., A.U.S. 


Ryan. M. J.. Sioux City (Topeka, Kan.) Major, A.U.S. 

Schwartz, J. W., Sioux City (APO 883, New York, 

N. Y.) Lt. Col., A.U.S. 

Tracy, J. S., Sioux City (APO 569, New York, 

N. Y.) Major, A.U.S. 

Worth County 

Westly, G. S., Manly (APO 927, San Francisco, 

Cal.) . Major. A.U.S. 


Wright County 

Aagesen, C. A.. Dows (APO 383. New York, N. Y.) 

Capt., A.U.S. 

Bird, R. G., Clarion (Fleet PO, San Francisco, 


Cal.) Lt. Comdr., U.S.N.R. 

Doles, E. A., Clarion (Spokane, Wash.) Capt., A.U.S. 

Gorrell, R. L., Clarion (Denver, Colo.) ... .P.A. Surg., U.S.P.H.S. 
Leinbach, S. P., Belmond (Farragut Air Base, Idaho) 

Missildine, W. H., Eagle Grove (APO 25, San Francisco. 

Cal.) Capt., A.U.S. 


(•) Reported missing in action, 
(t) Reported deceased in service, 
(i) Reported prisoner of war. 


EXAMINATIONS OF THE AMERICAN BOARD 
OF OBSTETRICS AND GYNECOLOGY 

The general oral and pathology examinations 
(Part II) for all candidates will be conducted at 
Atlantic City, New Jersey, by the entire Board from 
Thursday, June 14, through Tuesday, June 19, 1945. 
The Hotel Shelburne in Atlantic City will be the 
headquarters for the Board. Formal notice of the 
exact time of each candidate’s examination will be 
sent him several weeks in advance of the examina- 
tion dates. Hotel reservations may be made by 
writing direct to the Hotel. 

Candidates for reexamination in Part II must 
make written application to the Secretary’s Office 
not later than April 15, 1945. 

The Office of the Surgeon-General (U. S. Army) 
has issued instructions that men in service, eligible 
for Board examinations, be encouraged to apply and 
that they may request orders to detached duty for 
the purpose of taking these examinations whenever 
possible. Candidates in military or naval service 
are requested to keep the Secretary’s Office informed 
of any change in address. 

Deferment without time penalty under a waiver 
of our published regulations applying to civilian 
candidates, will be granted if a candidate in service 
finds it impossible to proceed with the examinations 
of the Board. 

Applications are now being received for the 1946 
examinations. For further information and applica- 
tion blanks, address Dr. Paul Titus, Secretary, 1()15 
Highland Building, Pittsburgh (6), Pennsylvania. 


CHANGE OF ADDRESS 

Help your central office to main- 
tain an accurate mailing list. 
Send your changes of address 
promptly to The Journal, 

505 Bankers Trust Bldg., 

Des Moines 9, Iowa. 


no 


Journal of Iowa Statk Medical Society 


March, 1945 


WOMAN’S AUXILIARY NEW: 


Mrs. Keith M. Chapler, Chairman of Press and Publicity Committee, Dexter, Iowa 


President — Mrs. Jay C. Decker, Sioux Citj' 
President-Elect — Mrs. Soren S. Westly, Manly 
Secretary — Mrs. Allen C. Starry, Sioux City 
Treasurer — Mrs. Arthur E. Merkel, Des Moines 


AMA PLATFORM 

The following platform of the American Medical 
Association was adopted by the House of Delegates 
at its meeting June 13, 1944: 

1. Availability of medical care of high quality to 

every person in the United States.^ 

A. In the extension of medical services to all 
people, the utmost utilization of qualified medi- 
cal and hospital facilities already established. 

B. The continued development of the private prac- 
tice of medicine, subject to such changes as 
may be necessary to maintain the quality of 
medical services and to increase their avail- 
ability, including the development and exten- 
sion of voluntary hospital insurance and vol- 
untary medical insurance. 

C. Expansion of public health and medical serv- 
ices consistent with the American system of 
democracy. 

D. The allotment of such funds as the Congress 
may make available to any state in actual need 
for the prevention of disease, the promotion of 
health, and the care of the sick on proof of such 
need. 

E. The principle that the care of the public health 
and the provision of medical service to the sick 
is primarily a local responsibility. 

F. The development of a mechanism for meeting 
the needs of expansion of preventive medical 
services with local determination of needs and 
local control of administration. 

G. The extension of medical care for the indigent 
and the medically indigent with local deter- 
mination and local control of administration. 

H. The establishment of an agency of federal 
government under which shall be coordinated 
and administered all medical and health func- 
tions of the federal government exclusive of 
those of the Army and Navy. 


JOINT COMMITTEE ON POSTWAR MEDICAL 
SERVICE 

The following address by Roger I. Lee, M.D., 
President-Elect of the American Medical Association, 
was given before the first conference of state presi- 
dents, presidentS-elect, and chairmen of standing 
committees of the Woman’s Auxiliary to the Ameri- 


can Medical Association held in Chicago November 
16 and 17, 1944, and is reprinted from the December 
1944 issue of the Bulletin: 

I would like to tell you briefiy about the activities 
of the Joint Committee on Postwar Medical Serv- 
ice. This is a joint committee of the American 
Medical Association, the American College of Phy- 
sicians and the American College of Surgeons. 

In order to determine what returning medical 
officers wanted, the Committee sent out 60,000 ques- 
tionnaires with the cooperation of Lt. Colonel Lueth. 
18,000 replies are already received, which was sur- 
prising indeed to the Committee. The replies, ac- 
cording to age groups, were closely similar. The 
older men want to return to their practices. The 
younger men, however, because of the fact that 
their medical careers were shortened in the acceler- 
ated program and because their medical experience 
in the service has been rather limited, often want 
two or three years in post-graduate work rather 
than the short refresher courses. 

The replies presented some very interesting pic- 
tures. Only 10 per cent want to remain in Gov- 
ernment service; some have notions of joining 
groups; not many are interested in industrial med- 
icine; very few have any ideas of wearing the 
academic toga of the professor in the medical school. 
It is obvious that we are going to need about twice 
as many interneships and residencies as we have 
had in the past, and the Council on Hospitals and 
Medical Education of the American Medical Asso- 
ciation is very active in this regard. 

This Committee was formed two years ago with 
the idea of aiding the returning medical officers. 
A sub-committee was appointed to confer with the 
Veterans Administration in Washington, which is 
empowered to administer benefits for returned serv- 
ice men. At first it appeared that the Veterans 
Administration would regard only those under 
twenty-five years of age as having had their train- 
ing and education interrupted by their entrance 
into service but now they have decided that all 
medical officers, regardless of age, will be regarded 
as having had their education interrupted. 

The men are to receive varying amounts of train- 
ing. They are entitled to $500 a year for tuition 
paid directly to the institution selected; hospitals 
providing advanced training are to be included in 
this category. There will be no distinction between 
officers and enlisted men. Everybody gets $50.00 a 
month for maintenance if single, and a little more if 
married. 

The Committee has plans to set up an office of 
information in Chicago at the American Medical 
Association headquarters for the returning medi- 
cal officers. The purpose of this bureau will be to 
tell these men where opportunities are available 
and where they can find whatever they want in the 


VoL. XXXV, No. 3 


111 


Journal of Iowa State Medical Society 


war of relocation. The timing- of this plan is, of 
course, very important and very difficult. The Sur- 
geon Generals of the Army and Navy have worked 
very closely with this Committee but it is impos- 
sible for them to tell when they will be able to send 
our medical men back home. A good deal depends 
on the action of Congress and whether it will be 
willing to make certain appropriations and whether 
it will vote some form of universal military service. 

The American Medical Association has very val- 
uable information as to what the returning medical 
officers want and is determined to give it to them if 
it is at all possible. 


WHITE TEETH* 

“Who said your teeth should be white? Not your 
dentist. ‘Who wants white teeth, anyway?’ asks the 
Council on Dental Therapeutics of the American 
Dental Association. The natural color of teeth is 
not white, except perhaps to the imaginative or un- 
informed writer of advertising copy; rather, it varies 
from pale ivory to a more or less pronounced yellow- 
ish hue. 

“As for stains, there are many variables involved 
in the formation of stains on teeth. Some stains are 
not on the teeth, but IN the teeth . . . 

“The Council on Dental Therapeutics has been con- 
ducting for fourteen years a vigilant crusade for 
public health. Established by the American Dental 
Association in 1930 to assist in the protection of the 
public from fraud and imposition, the Council op- 
erates to prevent unscrupulous manufacturers from 
foisting products on the public which may not only 
fail to fulfill extravagant promises, but may also 
work actual damage on the teeth and oral tissues . . . 

“Composed of twelve members chosen by the Amer- 
ican Dental Association on the basis of character 
and ability in their respective fields of biophysics, 
chemistry, bacteriology, medicine and dentistry, the 
Council operates in conjunction with a well equipped 
chemical laboratory in the ADA Bureau of Chem- 
istry. None of the members receives financial re- 
muneration for his services. A full-time secretary 
and staff are employed by the Council . . . 

“In the interest of public health, the American 
people should use only those brands of dentifrices 
which bear the seal of the Council and be advised not 
to rely on mouthwashes as curative or prophylactic 
agents. They should be advised to avoid toothache 
poultices, toothache "gums and toothache drops; not 
to rely on stain removers; not to eat excessive 
amounts of sweets; not to depend wholly on liquid 
dentifrices because they may not be efficient cleans- 
ing agents; and not to rely on chewing gum for im- 
provement of their oral health. Everyone should 
know that virtually his only hope of maintaining 
oral health is to visit his dentist at least every 
six months and to follow his advice in mouth 
hygiene. 

“The public should be informed that the knowledge 
of the Council members and the findings of the 


Bureau of Chemistry are at their disposal without 
charge. The Council, located in the headquarters of 
the American Dental Association at 222 E. Superior 
St., Chicago, 111., now answers thousands of inquiries 
from the public each year. It is hoped that this 
number will be multiplied many times when more 
people are told by their dentists the meaning behind 
the Council’s seal of acceptance.” 

♦Excerpts from Donald A. Wallace’s article “White Teeth” in 
the November, 1944, issue of Hygeia. 


Meeting of the Dallas-Guthrie Auxiliary 

Following a joint luncheon with the doctors in the 
Rotary Club room in Adel, the Dallas-Guthrie Auxil- 
iary met in the Public Library Thursday afternoon, 
January 18. Mrs. C. E. Porter of Redfield, retiring 
president, was in the chair. The minutes of the last 
regular meeting were read and approved ; the treas- 
urer and chairmen of standing committees presented 
annual reports; and the Hygeia chairman reported 
thirty subscriptions. 

Mrs. K. M. Chapler of Dexter, the new president, 
appointed standing committees for 1945. She stressed 
the fact that with a membership of twenty-two, many 
of whom are not active, there will be essential over- 
lapping of duties, but the Auxiliary will continue to 
function. Concentration will be centralized upon 
subscriptions to Hygeia and The Bulletin. 

The program consisted of questions and answers 
chosen from Dr. W. W. Bauer’s book “Health Ques- 
tions Answered.” ^rs. P. W. Beckman 


MEETING OF THE POLK COUNTY AUXILIARY 
Members of the Polk County Medical Auxiliary met 
for a luncheon meeting in Des Moines at Younkers 
Tea Room Friday afternoon, January 19. Election 
of officers was held and Mrs. Russell C. Doolittle was 
named president of the group for the ensuing year. 
Other officers elected were Mesdames George H. Wat- 
ters, president-elect; James W. Young, vice presi- 
dent; Byron M. Merkel, secretary; and Noble W. Irv- 
ing, treasurer. 


SPEAKERS BUREAU RADIO SCHEDULE 
WOI Tuesdays at 1:00 p. m. 

WSUI Thursdays at 9:00 a. m. 

March 6-8 American Red Cross 

Lauren R. Moriarty, M.D. 

March 13-15 The Care of Throat Infections 

John E. Stansbury, M.D. 

March 20-22 Common Symptoms of Gallbladder 

Disease Elliott C. Cobb, M.D. 

March 27-29 The Dangers of Food Poisoning 

Fred Montz. M.D. 


112 


Journal of Iowa State Medical Society 


March, 1945 


History of Medicine in Iowa 

Edited by the Historical Committee 

Dr. Walter L. Bierring, Des Moines, Chairman 
Dr. Henry G. Langworthy, Dubuque, Secretary Dr. John T. McClintock, Iowa City 
Dr. Murdoch Bannister, Ottumwa Dr. Frank E. Sampson, Creston 



Clyde A. Henry, M.D., Parson 


(Continued from last month) 

' Part IV 

A COMPENDIUM OF WAPELLO COUNTY MEDICAL HISTORY FROM 1853 TO 1945 


Not long after its reorganization in 1870, the 
activities of the Wapello County Medical Society 
spread to other sections of the state. Excellent 
programs were offered regularly, and physicians 
from surrounding towns and villages were in- 
vited to attend. This new movement of scientific 
and social intercourse proved to be so popular 
that guest speakers from Des Moines to Keokuk 
were soon participating. Finally, and in further- 
ance of this “Good Neighbor” policy, the Wapello 
County Medical Society extended a call to the 
physicians of adjacent and surrounding counties 
to unite in the formation of an Auxiliary Asso- 
ciation in which all who chose might share the 
responsibilities and benefits alike. Pursuant to 
this invitation, a meeting was held at the Lewis 
Opera House in Ottumwa, January 7, 1873. The 
following physicians were present and their names 
em'olled ; J. P. Grnwell, H. C. Huntsman, D. A. 
Hurst, F. W. Coolidge, all of Oskaloosa; W. E. 
Chambeidain of Beacon; W S. Lambert of Albia; 
J. C. Ware of Fairfield ; A. W. McClure of Mt. 
Pleasant; M. B. V. Howell and J. V. Bean of 
Moulton ; A. R. Weir and E. H. Brumbaugh of 
Agency City ; A. C. Olney and B. F. Hyatt of 
Chillicothe; G. L. Johnson of Eddyville; W. L. 
Orr. S. B. Thrall, J. Williamson, G. F. Foster, 
T. J. Douglass, S. R. Mitchell, S. C. McCullough, 
J. C. Hinsey, E. L. Lathrop, C. G. Lewis, and 
A. Hawkins of Ottumwa ; and W. W. Fierce of 
Bloomfield. 

The meeting was called to order by Dr. S. B. 
Thrall, who had served as chairman of the com- 
mittee on arrangements. Dr. T. J. Douglass was 
appointed chairman pro tem and J. V. Bean, sec- 
retary. Dr. W. L. Orr, then mayor of Ottumwa, 


delivered an address of welcome on behalf of the 
city, and Dr Williamson followed with a formal 
address on behalf of the Wapello County Medical 
Society. The necessary committees were ap- 
pointed to ]ierfect a permanent organization ; and 
after adopting a constitution and by-laws, the 
meeting was adjourned to meet again at seven 
o’clock, at which time officers were elected for the 
ensuing year, as follows ; President, H. C. Hunts- 
man ; vice president, M. B. V. Howell ; secretary- 
treasurer, Jefferson Williamson ; assistant secre- 
tary, G. L. Johnson; censors, S. B. Thrall, W. E. 
Chamberlain, D. A. Hurst, C. G. Lewis, and A. 
W. McClure. By unanimous vote. Dr. Williamson 
was declared permanent secretary of the new so- 
ciety — The Des Moines Valley Medical Associa- 
tion — the duties of which office he faithfully per- 
formed through the following ten years. During 
the first seven years, the Association met in Jan- 
uary and June of each year in various towns with- 
in the district. For three years annual meetings 
were held in like manner. In 1883 the Association 
voted to hold annual meetings permanently in Ot- 
tumwa, Wapello County, on the “first Thursday 
in June, or such time as the president and sec- 
retary shall name.” In accordance with this pol- 
icy, the Des Moines Valley Medical Association 
met annually for a period of fifty-five consecutive 
years, the last meeting having been held in Ot- 
tumwa on Thursday, April 28, 1938. An excel- 
lent program, beginning at 3 ;30 p. m. in Hotel 
Ottumwa, was successfully executed, at the con- 
clusion of which the following officers were elected 
for the year 1939; President, E.-B. Wilcox, Os- 
kaloosa; first vice president, John Dulin, Sigour- 
nev ; second vice president, Clyde Henry, Farson ; 


VoL. XXXV, No. 3 


Journal of Iowa State Medical Society 


113 


secretary-treasurer, E. B. Howell, Ottumwa ; cen- 
sors, E. B. Hoeven, Ottumwa : C. T. Slavin, Mora- 
via; and Burke Powell, Albia. However, the 1939 
meeting- was not called : nor has there since been 
a meeting of that old and honorable institution, the 
Des Moines Valley Medical Association, whose 
activities, from the day of its organization in 
1873, through the sixty-five consecutive years that 
followed, constitute such a colorful chapter in the 
history of medicine in A\Mpello County and south- 
eastern Iowa. Its standards were high, its fel- 
lowship warm and welcoming; the annual gather- 
ing of its distinguished membership served the 
purpose of its founders well. May its stimulating 


in Columbus. Ohio, in 1849. He attended lectures 
at Starling Medical College in 1851-52, obtained 
tbe degree B.A. at Kenyon College in 1851, M.D. 
at the University of New York in 1853, and M.A. 
at Kenyon College in 1855. He practiced a year 
with his father at Columbus, Ohio, before gradu- 
ating, and at Belle Center, Ohio, from April, 1854, 
to November, 1855. He then returned to Colnm- 
bus and married Mary Brooks. Soon after his 
marriage he came west and located in Ottumwa in 
May, 1856, where he successfully engaged in the 
practice of medicine until Eebruary, 1862, when 
he was appointed Surgeon in the Military Hospital 
at Keokuk, Iowa. In November of that year he 



PRESIDENTS OF THE IOWA STATE MEDICAL SOCIETY FROM WAPELLO COUNTY 
1. S. B. Thrall (1870) 2. Jefferson Williamson (1873) 3. J. C. Hinsey (1888) 4. D. C. Brockman (1905) 

5. John F. Herrick (1917) 6. Smith A. Spilman (1926) 7. Charles B. Taylor (1934) 


and stabilizing influence again prevail in Our Eield 
of Medicine if its activities are resumed at the 
close of this war. 

THE seven presidents 

Seven members of the Wapello County Medical 
Society became president of the Iowa State Medi- 
cal Society and served as follows; S. B. Thrall, 
1870; Jefferson Williamson, 1873; J. C. Hinsey, 
1888; D. C. Brockman, 1905; John E. Herrick, 
1917; S. A. Spilman, 1926; and Charles B. Tay- 
lor, 1934. 

Seneca Brozim Thrall was born in Utica, New 
York, on August 9, 1832, and died January 20, 
1888, at his home in Ottumwa. He studied medi- 
cine under his father. Professor PI. C. Thrall of 
Kenyon College, and at. Starling Medical College 


was commissioned Assistant Surgeon of the 13th 
Iowa V. I. and served with it in the 17th Army 
Corps until May, 1864, when he returned to Ot- 
tumwa and resumed civilian practice. 

Dr. Thrall became a member of the Iowa State 
Medical Society in 1859 and for more than a 
quarter of a century was one of its ablest and most 
influential members. He was strongly opposed to 
medical politics, and was one of a small group 
that successfully defended the interests of the 
State Society against a struggle between the Uni- 
versity Medical College at Iowa City and the Col- 
lege of Physicians and Surgeons of Keokuk, pre- 
venting either faction from gaining supremacy. 
Pie was also a member of the American Medical 
Association and served on many of its important 
committees. He was president of the Wapello 



114 


Journal of Iowa State Medical Society 


March, 1945 


County Medical Society in 1871 ; secretary of the 
Iowa State Medical Society in 1865; jiresident in 
1870; again secretary in 1873, which office lie 
held until 1877. He was a delegate to the AMA 
meeting in San Francisco in 1871, at which meet- 
ing he became an honorary member of the Cali- 
fornia State Medical Society. 

General Grant was an ardent chess player. 
So was Dr. Thrall. They met, during the Civil 
War, in many closely contested games. Years 
afterward President Grant was completing his 
round-the-world-tour via Ottumwa. A large 
crowd gathered as the train arrived. Scheduled 
only for a short stop, the General appeared on 
the rear platform to make a brief speech. 'Fhere 
was a commotion at one point near the fringe of 
the crowd, where a goggled and bewhiskered little 
man was struggling to make his way forward. 
The speech ended abruptly. 

“Make way for Thrall,” the General shouted ; 
for Thrall it was. And when he got to the car, 
with an outstretched hand and a friendly grimace 
Grant exclaimed, “Hello, Thrall, you old son-of- 
a-gun ! What are you doing here?” 

Dr. and Mrs. Thrall had three children — Frank 
B., Nellie, and Homer N. Mrs. Mary Brooks 
Thrall died in 1889, but the women of the Bible 
class she taught at the First Methodist Church, 
at her request, organized the Ottumwa Hospital 
Association in 1892. The last member of the 
family, Frank B. Thrall, died at the Ottumwa 
Hospital in June, 1945, at the age of eighty-five. 

Dr. S. B. Thrall died at the early age of fifty- 
six years, but the record of his brilliant achieve- 
ments constitutes a full page in the annals of 
Iowa Medicine. 

(To be continued) 


ROMANCES OF CARDIOLOGY 
Daniel J. Glomset, M.D., Des Moines 

(Continued from page 102) 

varsan has been used millions of times. It is 
used today by every practitioner of medicine. By 
its proper use syphilis can be cured, can be 
stamped out entirely. There is no need for any- 
one’s dying of syphilitic heart disease today. 
When physicians fully realize that medical edu- 
cation of the laity is their responsibility and in- 
telligently attack that part of their duty as citi- 
zens, syphilis will become an obsolete disease. 

Another, perhaps even greater, benefit came 
from the toils and tears of Paul Ehrlich. His 
work opened a new horizon in medical research. 
Ehrlich’s crazy idea of magic bullets worked. 
Substances could be made that would kill disease- 
producing germs without doing serious damage 
to the host. 


By the sweat and tears of other giants the “sulfa 
drugs” came into existence — and now penicillin. 
Only a few months ago, one of my colleagues 
reported the cure of a genuine case of subacute 
bacterial endocarditis by the use of penicillin — 
medicine marches on ! 

Cardiology has grown in wondrous ways since 
the publication of the De Motu Cordis; yet there 
remains much that is dark which-must be illumined, 
and much that is weak which must be raised and 
supported before it can justly be said that man 
has conquered the diseases of the heart. 


bibliography 

The factual bases of this brief account of the development of 
cardiologry were obtained from the sources which follow. 

GENERAL INFORMATION 

1. Garrison, F. H. ; History of Medicine. W. B. Saunders 
Company, Philadelphia, 1914. 

2. Herrick, J. B. : A Short History of Cardiologry. Charles 
C. Thomas Publishing Company, Springfield, Illinois, 1942. 

3. Major, R. : Classic Descriptions of Disease, first edition. 

Charles C. Thomas Publishing Company, Springfield, Illinois, 1932. 

4. Robinson, V. : Pathfinders in Medicine. Medical Life 

Press. New York, 1929. 

5. Willius, F., and K^s, T. E. : Cardiac Classics. C. V. 

Mosby Company, St. Louis, 1941. 

SPFXIAL INFORMATION ABOUT INDIVIDUAL MEN 
AND TOPICS 

1. Harvey — Osier, \V. : An Alabama Student, 295-334. Ox- 

ford University Press, New York, 1909. Camac, C. N. B. : Epoch- 
making Contributions to Medicine, Surgery and Allied Sciences, 
25-113. W. B. Saunders Company, Philadelphia, 1909. 

2. Corvisart — Bechet, P. E. : Jean Nicholas Corvisart, physician 
to the Emperor Napoleon. Ann. M. Hist., 461-470, 1940. Dally, 
J. F. H. : Jean Nicholas Corvisart. M. Record, cliii :233-237 
(April) 1941. 

3. haennec — Webb, G. B.: Rene Theophile Hyacinthe Laennec. 
Paul B. Hoeber, New York, 1928. 

4. Roentgen — Glasser, O. : Wilhelm Conrad Roentgen. Charles 
C. Thomas Publishing Company, Springfield, Illinois, 1934. 

5. Electrocardiography — Leaman, W. G. : History of electro- 
cardiography. Ann. M. Hist., 113-123, 1936. 

6. Mackenzie — Wilson. R. McN. : The Beloved Physician. Wil- 
liam Clowes and Sons, Ltd., London, 1928. 

7. Herrick — Herrick, J. B. : An intimate account of my early 

experience with coronary thrombosis. Am. Heart J., xxvii:l-l8 
(January) 1944. 

8. Hunter — Home, E. : A Short Account of the Life of the 

Late John Hunter. In: Hunter, J. : A Treatise on the Blood. 
London, 1794, xiii-lxvii. Graham, H. : The Story of Surgery, 

238-249. Doubleday Doran Company, New York, 1939. 

9. Withering — Roddis, L. H. : William Withering. Paul B. 
Hoeber, New York, 1936. Meakins, J. C. : William Withering: 
his contribution to medicine. Ann. Int. Med., xvi :327-S32 (Febru- 
ary) 1942. 

10. Ehrlich — DeKruif, P.: Microbe Hunters. Harcourt, Brace 
& Company, New York, 1926. 


PREVALENCE OF DISEASE 


Most Cases 


Disease 

Jan. '45 

Dec. ’44 

Jan. ’44 

Reported From 

Diphtheria 

. . . 21 

28 

22 

Woodbury, Dubuque 

Scarlet Fever . . . 

. . .389 

220 

389 

Polk, Clinton, Linn 

Typhoid Fever . . 

. . . 0 

0 

3 

For the State 

Smallpox 

. . . 0 

0 

2 

For the State 

Measles 

. . .127 

75 

521 

Guthrie, Woodbury 

Whooping Cough 

. . . 32 

25 

144 

Woodbury, Boone 

Brucellosis 

. . . 8 

13 

24 

Linn 

Chickenpox 

. . .354 

216 

261 

Dubuque, Woodbury, 

German Measles 

. . . 0 

2 

12 

Des Moines 
For the State 

Influenza 

. . . 0 

0 

7,462 

For the State 

Malaria 

. . . 4 

10 

0 

Page, Marshall 

Meningococcus 
Meningitis . . . 

. . . 8 

7 

8 

Polk 

Mumps 

. . .380 

127 

83 

Clayton, Dubuque. 

Pneumonia 

. . . 43 

32 

270 

Johnson 

Black Hawk. Mar- 

Poliomyelitis . . . 

. . . 0 

6 

0 

shall, Marion 
For the State 

Tuberculosis .... 

. . . 63 

49 

64 

For the State 

Gonorrhea 

. . .266 

171 

150 

For the State 

Syphilis 

. . .143 

122 

223 

For the State 


VoL. XXXV, No. 3 


Journal of Iowa State. ^klEDicAL Society 


115 


THE JOURNAL BOOK SHELF 


BOOKS RECEIVED 


LIPPINCOTT’S QUICK REFERENCE BOOK FOR MEDICINE 
AND SURGERY, a Clinical, Diagnostic, and Therapeutic Di- 
gest of General Medicine, Surgery, and the Specialties, 
Compiled Systematically from Modern Literature — By George 
E. Rehberger, M.D. Twelfth edition. J. B. Lippincott Com- 
pany, Philadelphia, 1944. Price, $15.00. 

ATLAS OF THE BLOOD IN CHILDREN— By Kenneth D. Black- 
fan, M.D., Late Thomas Morgan Rotch Professor of Pedia- 
trics, Harvard Medical School, Late Physician-in-Chief, In- 
fants’ and Children’s Hospitals, Boston ; Louis K. Diamond. 
M.D., Assistant Professor of Pediatrics, Harvard Medical 
School, Visiting Physician and Hematologist, Infants’ and 
Children’s Hospitals, Boston. With illustrations by C. Mer- 
rill Lehster,. M. D.. Associate Pediatrician, St. Luke’s Hos- 
pital, Bethlehem and Allentown General Hospital, Allentown, 
Pennsylvania. The Commonwealth Fund, New York, 1944. 
Price, $12.00. 

PRINCIPLES AND PRACTICE OF SURGERY— By W. Wayne 
Babcock, M.D., Emeritus Professor of Surgery, Temple 
University, Acting Consultant, Philadelphia General Hos- 
pital ; with the collaboration of thirty-seven members of the 
faculty of Temple University. Lea & Febiger, Philadelphia, 
1944. Price. $12.00. 

THE PATHOLOGY OF INTERNAL DISEASES— By William 
Boyd, M.D., Professor of Pathology and Bacteriology in the 
University of Toronto, Toronto : formerly Professor of Path- 
ology in the University of Manitoba, Winnipeg, Canada. 
Fourth edition, thoroughly revised. Lea & Febiger, Phila- 
delphia, 1944. Price, $10.00. 


BOOK 


INTERNS HANDBOOK 

By members of the Faculty of the College 
of Medicine, Syracuse University, under the 
direction of M. S. Dooley, M.D., Professor of 
Pharmacology, and Maynard E. Holmes, 
M.D., Professor of Clinical Medicine. Co- 
Chairman, Publication Committee. Third 
edition. J. B. Lippincott Company, Phila- 
delphia, 1944. Price, $3.00. 

This is the third edition of Interns Handbook, a 
guide, especially in emergencies, for the intern and 
the physician in general practice. The co-authors, 
with the assistance of the members of the faculty of 
the College of Medicine, Syracuse University, have 
succeeded in bringing the contents of this authori- 
tative pocket size volume completely up to date. 

The entire book is filled with essential facts and 
practical information regarding differential diagno- 
sis, management, and treatment of the common dis- 
eases and their complications in man. It aims purely 
to serve as a quick and handy reference book, and it 
is amazing that so great a wealth of material can be 
compacted into such a small volume. 

Among its features is the section on endocrine 
disturbances. This confused subject is clearly out- 
lined and simplified in an understandable mqnner. 
Part Four presents pre- and postoperative surgical 
procedures, rudiments of anesthesia, management of 
gynecologic and obstetric emergencies, and the 
essential points of the various surgical specialties. 
Part Five is devoted to therapy. The technic of bone 
marrow infusion is described in detail. The discussion 


MILITARY MEDICAL MANUALS. MANUAL OF CLINICAL 
MYCOLOGY — Prepared under the Auspices of the Division 
of Medical Sciences of the National Research Council. W. B. 
Saunders Company, Philadelphia, 1944. Price, $3.60. 

THE 1944 YEAR BOOK OF GENERAL SURGERY— Edited by 
Evarts A. Graham. M.D., Professor of Surgery, Washing- 
ton University School of Medicine; Surgeon-in-Chief of the 
Barnes Hospital and of the Children’s Hospital. St. Louis. 
The Year Book Publishers, Inc., Chicago, 1944. Price, $3.00. 

PATIENTS HAVE FAMILIES — By Henry B. Richardson, M.D., 
Associate Professor of Clinical Medicine, Cornell University 
Medical College: Attending Physician, New York Hospital; 
Visiting Physician, Bellevue Hospital. The Commonwealth 
Fund, New York, 1945. Price, $3.00. 

OPERATIONS OF GENERAL SURGERY— By Thomas G. Orr, 
M.D., Professor of Surgery, University of Kansas School of 
Medicine, Kansas City, Kansas. W. B. Saunders Company. 
Philadelphia, 1944. Price, $10.00. 

SURGERY OF THE HAND — By Sterling Bunnell, M.D., honor- 
ary member of American Academy of Orthopedic Surgeons ; 
member of American Association of Plastic Surgeons and of 
American Society of Plastic and Reconstructive Surgery. 
J. B. Lippincott Company. Philadelphia, 1944. Price, $12.00. 

THE ART OF RESUSCITATION— By Paluel J. Flagg, M.D., 
Chairman, Committee on Asphyxia, American Medical As- 
sociation ; President and Founder of the Society for the Pre- 
vention of Asphyxial Death, Inc. Reinhold Publishing Cor- 
poration, New York, 1944. Price, $5.00. 


on blood transfusion is excellent in that it gives a 
clear-cut presentation of the Rh factor, methods of 
typing and combating reactions. There is a com- 
prehensive summary on the use of sulfonamides and 
penicillin. 

The book will undoubtedly pay dividends as an 
ever-ready companion in the intern’s pocket or in 
the physician’s bag. T. A. 


MODERN CLINICAL SYPHILOLOGY 

By John H. Stokes, M.D., Professor of 
Dermatology and Syphilology, School of 
Medicine and Graduate School of Medicine, 
University of Pennsylvania; Herman Beer- 
man, M.D., Assistant Professor of Derma- 
tology and Syphilology, School of Medicine 
and Graduate School of Medicine, Univer- 
sity of Pennsylvania; and Norman R. In- 
graham, Jr., M.D., Assistant Professor of 
Dermatology and Syphilology, School of 
Medicine, University of Pennsylvania. Third 
edition, reset. W. B. Saunders Company, 
Philadelphia, 1944. Price, $10.00. 

This volume, as could be expected, contains all the 
available data concerning syphilis and its treatment 
known up to the time of printing. Since syphilis is 
a disease of many manifestations, it is to be ex- 
pected that it would require much space and some 
duplication to cover all of them. The authors have 
made some items easier to find than in previous edi- 


REVIEWS 


116 


Journal of Iowa Statu Medical Society 


March, 1945 


tions, but the book is still not designed for the busy 
general practitioner who desires a (luick and con- 
cise answer to a specific question. The volume is an 
excellent textbook on syphilis and all the answers are 
included if one has the time to search for them and 
read a considerable amount of material of indirect 
bearing on the subject. While some improvement 
was made in organization of material, the reviewer 
was disappointed that more was not accomplished. 
It would have been nice to have seen some moderniza- 
tion of some of the illustrations which sei've to “date” 
the book. 

New material has been injected throughout the 
book, obsolete material has been eliminated, and new 
chapters on penicillin and newer treatment schedules 
have been added. So far as the material on penicillin 
is concerned, it serves as a good historical sketch on 
the subject, but the data on its therapeutic use and 
value was “ancient history” before the ink was dry. 
This is no reflection on the authors but rather an in- 
dication of how rapidly things medical are moving 
at the moment. The references to intensive treat- 
ment schedules seem, unfortunately, to be colored by 
the authors’ opinion rather than by an evaluation of 
the factual data. 

The subject matter on congenital syphilis is a dis- 
tinct improvement over previous editions, a contribu- 
tion that has heen much needed. The chapter on 
syphilis in public health and military medicine is con- 
spicuous for the authors’ apparent lack of experience 
in both fields, and adds very little that is helpful on 
the subject. 

All in all, it is unfortunate that the authors chose 
this particular time to come forth with a new edition. 
Events in the field of syphilology are happening with 
such rapidity that data would have to be changed 
before the printer’s proofs could be obtained. Aside 
from this, which alone would discourage a printed 
document, this edition offers so little improvement 
over previous issues as to have been scarcely worth 
the effort, time, or expense. R. M. S. 


FEMALE ENDOCRINOLOGY 

By Jacob Hoffman, M.D., Demonstrator in 
Gynecology, Jefferson Medical College; Pa- 
thologist in Gynecology, Jefferson Hospital; 
formerly Research Fellow in Endocrinology 
and Director of the Endocrine Clinic, Gyne- 
cological Department, Jefferson Hospital, 
Philadelphia, W. B. Saunders Company, 
Philadelphia, 1944. Price, ^10.00. 

Part I of this text takes up the physiology of the 
female endocrine system, and a chapter on the male 
is also included. The author presents in a conserva- 
tive and clear-cut way the known facts of endo- 
crinology. The twenty-two chapters of Pai-t I can 
be recommended highly because all speculative and 


controversial matter has been eliminated, making 
reading easy and definitely instructive. 

Part II considers the clinical aspects of endocrin- 
ology, together with the endocrinopathies. These six- 
teen chapters are complete and make an excellent 
addition to any reference library because of the ex- 
tensive bibliography at the end of each chapter. 

Part III deals with all laboratory procedures in 
simplified and workable forms to carry out investi- 
gation in practical endocrinology. 

While the book has seven hundred and eighty-eight 
pages with one hundred and eighty-one illustrations, 
it presents the subject in a most satisfactory manner 
and should be found in the library of both gynecolo- 
gist and general practitioner. L. E. K. 


THE PRINCIPLES AND PRACTICE OF 
OBSTETRICS 

By Joseph B. DeLee, M.D., formerly Pro- 
fessor of Obstetrics and Gynecology, Emeri- 
tus, University of Chicago, Consultant in 
Obstetrics, Chicago Lying-in Hospital and 
Dispensary, Consultant in Obstetrics, Chi- 
cago Maternity Center; and J. P. Green- 
hill, M.D., Attending Obstetrician and 
Gynecologist, Michael Reese Hospital, Ob- 
stetrician and Gynecologist, Associate Staff, 
Chicago Lying-in Hospital, Attending Gyne- 
cologist, Cook County Hospital, Professor of 
Gynecology, Cook County Graduate School 
of Medicine. Eighth edition, entirely reset. 

W. B. Saunders Company, Philadelphia, 
1943. Price, $10.00'. 

Dr. DeLee’s textbook has ranked high in medical 
schools for the past thirty years. This edition, which 
Dr. Greenhill helped to prepare, has many advan- 
tages over the old. English terms have been substi- 
tuted for many of the old Latin terms, making it a 
more modern and comprehensible text; the newer 
classifications of many pathologic aspects of preg- 
nancy are included; the arrangement of the text 
makes a clear, concise presentation of the material, 
rather than the state of confusion found in former 
editions. The treatise makes an ideal text for the 
student and is now so written that it is a handy ref- 
erence for the practitioner. 

The volume is excellent on operative obstetrics, 
being rather definite in indications for operative de- 
liveries and also giving detailed description of pro- 
cedures. The discussion of pathology during preg- 
nancy, delivery, and postpartum was particularly im- 
pressive, since this is a section which is often slighted 
in textbooks on obstetrics. 

The reviewer believes this text adequately meets 
the demands of the present-day student and practi- 
tioner. N. W. I. 


\’0L. XXXV, No. 3 


Journal of Iowa State ^Medical Society 


117 




SOCIETY PROCEEDINGS 



Audubon County 

The Audubon County Medical Society met Tues- 
day evening-, January 16, at the Victory Cafe in 
Audubon. Election of officers was held with the 
following results: Dr. Leroy E. Jensen of Audu- 

bon, president; Dr. William R. Koob of Brayton, 
vice president; Dr. William H. Halloran of Audubon, 
secretary-treasurer; Dr. Peter E. James of Elkhorn, 
delegate; and Dr. Peder Soe of Kimballton, alter- 
nate. 


Boone-Story Society 

A joint meeting of the Boone and Story County 
Medical Societies was held at the Holst Hotel in 
Boone Thursday, February 15, at 6:30 p. m. Lt. 
Col. Robert S. Shane, Medical Advisor of the Se- 
lective Service System of Iowa, was the guest of 
honor. Several Des Moines physicians were also 
present for the meeting. 


Clayton County 

At a recent meeting of the Clayton County Med- 
ical Society Dr. Placido R. V. Hommel of Elkader 
was elected president of the group. Other officers 
named were Dr. Edward C. Meggers of McGregor, 
vice president; Dr. Theodore W. Lichter of Edge- 
wood, secretary-treasurer; and Dr. William J. Mc- 
Grath of Elkader, delegate. 


Des Moines County 

A dinner meeting of the Des Moines County Med- 
ical Society was held in Burlington at Hotel Bur- 
lington, Tuesday, February 13, at 6:00 p. m. The 
scientific program consisted of an address by An- 
drew C. Woofter, M.D., Director of the Venereal 
Disease Division of the State Department of Health, 
on Venereal Disease Control and the Use of Peni- 
cillin in the Treatment of Venereal Disease, and 
also a discussion of Medical Insurance in the State 
of Iowa by Bernard J. Dierker, M.D., of Fort 
Madison. 


Hardin County 

The Hardin County Medical Society held its an- 
nual dinner meeting in Iowa Falls Tuesday evening, 
January 23, at which time officers were elected for 
1945. Dr. David M. Nyquist of Eldora was named 
president; Dr. Ernest L. W. Brown of Iowa Falls, 
vice president; and Dr. William E. Marsh of Eldora, 
secretary. 


Howard County 

Following the death of Dr. George Kessel of 
Cresco, the Howard County Medical Society passed 
the following resolution of respect: 

“Be It Resolved, that we deeply regret the pass- 
ing, on January 29, 1945, of Dr. George Kessel, 
eminent artist and pioneer in medicine, surgery, 
philanthropy, and community spirit. 

“Be It Also Resolved, that we feel deeply the 
loss to our Society and to the entire profession be- 
cause of his ability, integrity, friendliness, and a 
■spirit of helpfulness in all activities pertaining to 
organized medicine. 

“Be It Further Resolved, that these resolutions 
become part of the permanent record of the Howard 
County Medical Society and that a copy be sent 
to his family, the Howard County Times, the Cresco 
Plain Dealer, and the State Medical Journal.” 

Francis E. Giles, M.D., Secretary 

Jackson County 

The Jackson County Medical Society honored Dr. 
David N. Loose of Maquoketa at a dinner Friday 
evening, February 2, in observance of his ninetieth 
birthday on February 6. The meeting was held in 
the Legion Hall in Maquoketa and was attended by 
more than fifty physicians, dentists, and druggists 
of the county. At a brief business session Dr. Earl 
V. Andrew of Maquoketa was elected president of 
the Society for 1945 and Dr. John J. Tilton of Ma- 
quoketa, secretary. The program was devoted to 
reminiscing on early days in the medical profession. 
Dr. Loose told of coming from Michigan to Zwingle 
in 1877 and then to Maquoketa in 1882, where he 
opened a drug store in connection with his practice 
of medicine. Other speakers were Drs. John C. 
Dennison, Edward A. Hanske, and Milo W. Moul- 
ton, all of Bellevue, and A. L. Broxam and E. L. 
Hinckley of Maquoketa. The latter were employed 
in Dr. Loose’s drug store in early days, and Dr. 
Dennison had worked in another drug store in Ma- 
quoketa. Frederick J. Swift. M.D., Secretary 


Johnson County 

The Johnson County Medical Society held its reg- 
ular monthly meeting in Iowa City at Hotel Jef- 
erson Wednesday, February 7, at 6:00 p. m. The 
usual business meeting- was followed by a scientific 
program consisting of a clinicopathologic confer- 
ence presented by Dr. A. L. Sahs of the Depart- 
ment of Neurology, and Drs. W. S. Pheteplace, 
J. L. Carter, and H. P. Smith of the Department of 
Pathology. Rubin H. Flocks. M.D., Secretary 


118 


Journal of Iowa State Medical Society 


March, 1945 


Lee County 

The Lee County Medical Society held its annual 
dinner meeting in Fort Madison at the Anthes Ho- 
tel Wednesday evening, January 31. Preceding the 
dinner, an address was presented by Dr. Donald 
Cook of Lake Zurich, Illinois. A business meeting 
and discussion of the Iowa Medical Service Plan fol- 
lowed the dinner. 


Scott County 

The monthly meeting of the Scott County Medical 
Society was held in Davenport at the Lend-A-Hand 
Club Tuesday, February 6, at 6:00 p. m. The 
guest speaker of the evening was Frank R. Peter- 
son, M.D., Professor of Surgery at the State Uni- 
versity of Iowa College of Medicine, who presented 
an illustrated lecture on Conservative and Operative 
Treatment of Varicose Veins. , 

Leo J. Miltner, M.D., Secretary 


Wapello County 

The March meetings of the Wapello County Med- 
ical Society are scheduled for March 6 and March 
20 at St. Joseph Hospital in Ottumwa. At the 
Meeting on March 6 Vernon S. Downs, M.D., of 
Ottumwa will discuss Pulmonary Embolism. Clyde 
A. Henry, M.D., of Farson will present a paper 
on the History of Medicine in Wapello County at 
the meeting to be held March 20. 


Washington County 

The Washington County Medical Society held a 
dinner meeting Thursday evening, January 25, at 
the Nurses Home in Washington. Following din- 
ner, Ruben Nomland, M.D., Professor of Derma- 
tology and Syphilology at the State University of 
Iowa College of Medicine, presented an illustrated 
lecture on The Diagnosis and Treatment of Early 
Syphilis. S Kyle, M.D., Secretary 


PERSONAL MENTION 

Colonel John I. Marker of Davenport is now on 
terminal leave and will be discharged from the Army 
April 28, 1945. He has resumed his association with 
Dr. William H. Rendleman and is limiting his prac- 
tice to nervous and mental diseases. Colonel Marker 
has been on active duty since March, 1941. 


Captain Lawrence G. Schaeferle of Gladbrook, 
who has been on active duty in the Army since May, 
x941, has received the Bronze Star medal “for heroic 
achievement in connection with military operation 
against the enemy in the vicinity of Saint-Laurent 
sur-Mer, Normandy, France, June 6, 1944.” The cita- 
tion says: “Although subjected to heavy enemy fire. 
Captain Schaeferle remained on an exposed beach 
administering first aid and in the evacuation of the 
seriously wounded. His heroic devotion to duty 
saved many lives.” 


Major Harry G. Marinos has been honorably re- 
tired from the Army and has resumed his practice 
of medicine in Mason City where he is associated 
with Dr. Leslie W. Swanson. Major Marinos was 
called into active service in February, 1941, and went 
overseas in March, 1942. He spent thirty months in 
the Pacific theater. 


DEATH NOTICES 

Barnes, Frederick Louis, of Oskaloosa, aged sev- 
enty, died January 28 following a long illness. He 
was graduated in 1899 from the University of Illi- 
nois College of Medicine, and at the time of his 
death was a life member of the Mahaska County 
and Iowa State Medical Societies. 


Helgesen, Peter Andrew, of Lake Mills, aged 
seventy-six, died suddenly in Phoenix, Arizona, 
January 19, of a heart ailment. He was graduated in 
1891 from the College of Physicians and Surgeons 
at Keokuk, and at the time of his death was a mem- 


Kessel, George, of Cresco, aged eighty-eight, died 
January 29 following a heart attack. He was grad- 
uated in 1885 from Rush Medical College, and at 
the time of his death was a life member of the 
Howard County and Iowa State Medical Societies. 


Rusk, Lester Daniel, of Sioux City, aged seventy- 
two, died January 22 after a short illness. He was 
graduated in 1907 from the Sioux City College of 
Medicine, and at the time of his death was a mem- 
ber of the Woodbury County and Iowa State Med- 
ical Societies. 


Snitkay, Carl John, of Belle Plaine, aged seventy, 
died February 5 following an extended illness. He 
was graduated in 1901 from the State University 
of Iowa College of Homeopathic Medicine, and had 
long been a member of the Benton County and 
Iowa State Medical Societies. 


Steinle, George Henry, of Burlington, aged fifty- 
one, died February 11 after an extended illness. 
He was graduated in 1917 from St. Louis University 
School of Medicine, and at the time of his death 
was a member of the Des Moines County and Iowa 
State Medical Societies. 


Thatcher, Orville Donald, of Fort Dodge, 
aged thirty-one, has been reported dead by 
the War Department. Captain Thatcher, Army 
Flight Surgeon, had previously been reported 
missing in action following a mission over 
France June 22, 1944. He was graduated in 
1937 from the State University of Iowa Col- 
lege of Medicine, and at the time of his death 
was a member of the Webster County and 
Iowa State Medical Societies. 






The JOURNAL 

of the 

Iowa State Medical Society 


'iimnMitMMMtimi 


VoL. XXXV 


Des Moines, Iowa, April, 1945 


No. 4 



Members of the Iowa State Medical Society: 


Planning a postwar medical program this year assumes a special significance 
to the faculty of the College of Medicine. We are reminded of the debt that 
we owe to similar postwar planning more than three quarters of a century ago. 

During the war between the states, as during all such destructive periods, 
medical standards suffered. In the years immediately following the catastrophe 
a few progressive physicians and other citizens of the state, dissatisfied with 
this quality of medical practice, demanded better training. With a vision well 
in advance of their time, they realized that if medical education in America 
were to achieve the place it merited, schools of medicine must, like those in 
Europe, be associated with great universities. Under the aggressive leadership 
of Dr. W. F. Peck of Davenport their efforts were rewarded in 1869 by the estab- 
lishment of a Department of Medicine in the State University of Iowa. The first 
class was graduated in 1870. 

We hope to be permitted to celebrate this seventy-fifth birthday with special 
clinics September 27 and 28. We trust that you will mark these dates and plan 
to join us in commemorating this event. 

In presenting to you this third annual College of Medicine issue of our State 
Medical Journal I am taking the liberty of calling it our Diamond Jubilee Anni- 
versary number. 

I want to express my appreciation to the Editor for the opportunity to bring 
you this message, and to extend a greeting to each of you. The exigencies of 
the day will not permit us to meet at our annual session and renew the friend- 
ships of many years. 

To our friends in the armed services, an especial greeting and our deepest 
regret that many of you cannot be with us in September. 

Sincerely yours, 

E. M. MacEwen, M.D., Dean 



120 


Journal of Iowa State Medical Society 


April, 1945 


Editor’s Note: It was with sincere regret that the Publication Committee deemed it neces- 
sary, because of limitations in paper stock, to hold over one manuscript submitted for publi- 
cation in the Diamond Jubilee Anniversary issue. This article from the Department of In- 
ternal Medicine, entitled “Medical Management of Uncomplicated Peptic Ulcer” and prepared 
by W. 1). Paul, M.D., and C. Rhomherg, M.D., will appear in the May issue of the Journal. 


OBSERVATIONS ON BROMIDE 
INTOXICATION 
C. H. Millikan, M.D. 

Bromine was discovered in 1826 by the Erench 
chemist, BalarcL^ In 1840, Graf^ introduced 
bromides into therapy. Since that time the use 
of bromides has increased until they are among 
the most frequently prescribed of all medicines. 
Barbour, et al.,^ found that under the national 
health insurance plan in England one of every ten 
prescriptions contained bromides as the principal 
ingredient. A prescription ingredient survey in 
Lafayette, Indiana, by research workers of the 
Purdue University School of Pharmacy,^ gave 
sodium bromide fifth place in a list of 689 official, 
nonofficial, and proprietary items, ranked according 
to their frequency of use. This popularity is 
largely due to the quieting effect on the higher 
centers produced by the drug. Pavlow® explained 
the beneficial effect of bromides thus : Bromides 
act on the inhibitory process ; they strengthen in- 
hibition by concentrating it at a definite point in 
the hemispheres ; namely, the point at which the 
process originated. Bromide is excreted from the 
body by the kidneys, and since the observations of 
Laudenheimer® in 1900 it has been known that 
bromide is retained in the body and accumulates 
until such a concentration is reached that the 
bromide intake and output are in a state of equi- 
librium. Because of this property of accumula- 
tion, it is possible for the blood serum bromide 
level to reach a height sufficient to cause a state 
of chronic intoxication. During the past fifteen 
years many reports have appeared in the literature 
describing the syndrome of bromide intoxication, 
bromism, and bromide psychosis. Many of these 
papers review a series of cases, in each instance 
alleged to be examples of chronic poisoning due to 
bromides. In one instance the authors report as 
many as 400 cases of chronic bromide intoxication 
at a single hospital. Compared with this amazing 
number of cases, intoxication is seldom seen at the 
State University of Iowa Hospitals. During the 
last seven years there have been 68,761 admissions 
to this hospital, and only 33 of that number were 
diagnosed as having any form of intoxication due 
to bromides. The incidence of bromide intoxica- 
tion was .048 per cent. Recently, Liebman and 
Richman’’’ published a study of the blood serum 

From the Department of Neurology, University Hospitals. 

Aided by a grant from the Institute for the Study of Analgesic 
and Sedative Drugs. 


bromide level in 145 consecutive admissions to the 
Bliss Institute. Of that number only one patient 
had a blood serum bromide level higher than 150 
milligrams per cent. The authors concluded that 
bromides did not play a great role in the production 
of symptoms of patients admitted to the Bliss Insti- 
tute. In contrast to these figures, Sensenbach® 
writes, “From January, 1943, to December, 1943, 
20 cases of bromide poisoning were treated in the 
medical wards of the North Carolina Baptist Hos- 
pital, a relatively small service of 40 beds.” The 
author does not include the total number of hos- 
pital admissions for that same period of time, so 
we know nothing about the incidence of intoxica- 
tion at the North Carolina Baptist Hospital. 

A review of the literature concerning bromide 
intoxication shows that there are many reasons for 
this difference of opinion about the frequency of 
the occurrence of poisoning due to bromides. 
Many authors seem to be confused about the 
criteria necessary for the diagnosis of bromide in- 
toxication. As early as 1933, Levin® reviewed 
these criteria. In general they are as follows : 

1. “We must know whether the psychosis be- 
gan before or after the intoxication began.” 
(Whether the symptoms and signs were present 
before, or developed during the ingestion of bro- 
mide.) 

2. “We must consider the duration of the psy- 
chosis after the discontinuance of the bromides. 
Usually, a bromide psychosis clears up in a short 
time — generally, from two to three weeks — after 
discontinuance. We must be careful not to con- 
fuse the mental state produced by^ bromides with 
the underlying psychosis.” (Patients whose men- 
tal abnormality is due to the presence of an ex- 
cess amount of bromide return to their prebro- 
mide-ingestion mental state when the drug is 
stopped.) 

3. “The existence of a bromide intoxication, as 
shown by the Walter-Hauptmann test.” (The 
Walter-Hauptmann test is the method used by 
Levin for determining the blood serum bromide 
level.) 

To these three criteria should be added a fourth : 
that there should be no other drug intoxication or 
disease present which could mimic the syndrome 
of bromide intoxication. 

The reports in the literature, describing many 
cases of alleged bromide intoxication, do not ful- 
fill these criteria. Curran,^® for instance, wrote 
concerning 50 cases of intoxication due to bro- 


VoL. XXXV, No. 4 


121 


Journal of Iowa State Medical Society 


mides. He was unable to report what kind of drug 
was given, the amount, or the time over which it 
was administered. Many of his patients did not 
recover, as do those having bromide intoxication. 
Sixteen of them were ultimately sent out to other 
institutions, and 13 of these were subsequently 
diagnosed as having an entirely different mental 
disease. No blood bromide determinations were 
made on 20 of the patients. Ten patients of the 
series were taking another drug, or even more than 
one other drug, at the same time that they were 
supposed to be taking bromides. In 1938, Hanes 
and Yates^^ wrote an analysis of 400 cases of 
alleged chronic bromide intoxication. These au- 
thors gave no details about any individual cases. 
After reading their article we do not know how 
many of the patients described were taking bro- 
mides, how many of them had mental symptoms 
before they began to take any medication at all, how 
many of them became mentally clear after their 
hospital stay, how many of them had organic brain 
pathology, or how many of them had been taking 
more than one drug before their admission to the 
hospital. It is interesting to note that 177 of the 
400 cases reported in this article had blood serum 
sodium bromide levels between 50 and 100 milli- 
grams per cent. This means that the actual blood 
serum bromine content was between 38 and 77 
milligrams per ICX) cubic centimeters. Other au- 
thorities believe that such a value is far below the 
level needed to produce a bromide intoxication. 
Sensenbach,® in his recent publication, does not 
fulfill these simple criteria in a single case of the 
49 he writes of as being examples of “bromide in- 
toxication.” Craven,^^ Cuttino,^^ Detweiler,^^ 
Diethelm,^^ Garrard,^® Gundry,^'^ Cheavens, et 
al.,’^® Tod and Stalker,^® Wagner and Bunbury,^® 
and Wohl, et al.,^^ are but a few of the authors 
who have each reported a number of patients diag- 
nosed as having bromide intoxication. Not one 
of these reports contains a statement to the effect 
that all of the cases recorded fulfill any set of 
criteria for diagnosis. 

A diagnosis of bromide psychosis was made on 
a patient recently admitted to the Neurology Serv- 
ice of the State University of Iowa Hospitals. 
Had this patient been sent out of the hospital 
after only a few days of observation and treatment, 
the diagnosis would have remained the same. Aft- 
er an extended period of observation it became 
clear that there was a psychiatric disorder present, 
which was much more fundamental than a toxic 
psychosis. The details of the case are as follows : 

CASE REPORT 

C. D., a white woman fifty years of age, was ad- 
mitted to the hospital accompanied by a graduate 
nurse. The patient was unable to answer questions. 

The history, obtained from outside sources, re- 


vealed that the patient had been nervous all of her 
life. For the three mouths prior to admission to the 
hospital she had been taking a teaspoonful of a salty 
liquid medicine evei’y three hours. This medicine had 
been prescribed for her by the local physician. A 
week before admission she began to act queerly. She 
was inattentive, and as time passed gradually be- 
came semistuporous. The day before admission she 
became restless, and appeared to be having delusions 
and hallucinations. 

On physical examination the positive findings 
were: incontinent, dehydrated, noisy, and inacces- 
sible. Routine examinations of the urine, blood, and 
spinal fluid were negative. The blood serum bromide 
level was 273 milligrams per cent by the Brodie- 
Friedman method. A diagnosis of bromide intoxica- 
tion was made. 

Physiologic salt solution was given daily by vein, 
in amounts sufficient to provide a daily intake of 15 
grams of sodium chloride. Enough additional fluid 
was given to make the daily average intake 4,000 
cubic centimeters. The patient had many delusions 
and hallucinations, and responded to these with yells, 
screams, and a generally resistive mood. 

At the end of the first nine days of treatment the 
blood serum bromide level was 98 milligrams per 
cent. That day she cried, yelled, laughed, fought, 
and carried on conversations with imaginary individ- 
uals. On the eleventh hospital day the patient was 
able to take fluids and sodium chloride by mouth. 

Twenty-one days after admission the blood serum 
bromide level was 4.5 milligrams per cent. That day 
the patient was restless, disoriented, hallucinated, 
and resistive. At times she appeared markedly de- 
pressed. 

After six weeks in the hospital the patient contin- 
ued to be depressed. She cried a great deal, mum- 
bled, and was violent at times. Members of the De- 
partments of Neurology and Psychiatry agreed on a 
diagnosis of involutional melancholia. 

COMMENT 

It should be noted that when this patient was 
admitted to the hospital a clinical diagnosis of 
bromide psychosis was made. This was sub- 
stantiated by the finding of a high concentra- 
tion of bromide in the blood serum. However, on 
further observation it became apparent that the 
abnormal findings had not been produced solely by 
an excessive drug intake ; and, finally, it was con- 
cluded that the blood serum bromide level was re- 
sponsible for only a small part of the patient’s 
psychic upset. The latter was an involutional mel- 
ancholia, the signs of which persisted after the 
blood serum bromide was entirely normal. 

Some authors make the assumption that any 
patient having a blood bromide value of 75 milli- 
grams per cent or more has the drug present in 
a pathologic amount. Cuttino,^^ for instance, re- 
ports that out “of 1,947 routine analyses run, 189, 
or 9.6 per cent, were positive in pathological 
amount; i. e., 75 milligrams or more per 100 cubic 
centimeters of blood.” This is, obviously, a mis- 
conception in view of the reports by Barbour, 
Novick,^^ Arieff,^"* Sippe and Bostock,^^ Minski 
and Gillen,^® and Barbour, et al.,^ of having seen 
patients with blood serum bromide levels well over 


122 


Journal of Iowa State Medical Society 


April, 1945 


200 niilligranis per cent who showed no signs of 
intoxication. 

Considering the inaccuracies descrihed above, it 
is apparent tliat we know very little about the 
actual incidence of the occurrence of bromide in- 
toxication in hospitals the country over, and, in 
relation to the total amount of bromide consumeil 
in the United States each year, we know nothing 
about the incidence of intoxication produced by 
the drug. 

Katzenelbogen, et al.,^‘ Claiborne,”*^ Preu, et 
al.,-‘‘* and others agree that it is absolutely neces- 
sary to prove the presence of an increased amount 
of bromide in the blood before making a final 
diagnosis of bromide intoxication. There are 
numerous methods of making this determination. 
Most of the blood bromide values recprded in tbe 
literature have been made by using the Wnith 
method, or some modification of it. In this method 
gold chloride is added to a protein free filtrate of 
serum. If bromide is present beyond that usually 
found, there is a color change in the mixture from 
yellow to brown due to the formation of gold 
bromide. The degree of color change is propor- 
tionate to the concentration of gold bromide 
formed. As Wuth^" himself has pointed out. his 
method is subject to considerable inherent error 
at both high and low serum bromide levels. It 
should also be noted that in making the determi- 
nation the solution of gold ■H)romide obtained is 
compared with standard tubes containing sodium 
bromide, previously treated with gold chloride, and 
the result is, therefore, expressed in terms of milli- 
grams of sodium bromide present per 100 cubic 
centimeters of blood serum, and not in terms of 
pure bromine. Gray and Moore^^ show that there 
are errors in the method in addition to the ones 
described by Wuth, and conclude that all of these 
“have been overlooked by those writers who at- 
tempt to correlate exactly the symptomatology 
with hlood concentrations in bromide intoxica- 
tion.” The gold chloride method, because of its 
simplicity, is the one of choice for the general 
practitioner ; it should be remembered, however, 
that it is not chemically accurate. 

Many authors have attempted to determine the 
blood bromide concentration at which intoxication 
begins. Table I shows the varying report of the 
blood concentrations at which intoxication is said 
;o begin. The second column gives the number of 
patients observed by each author. From the study 
of the given number of patients, each writer at- 
tempted to estimate the hlood bromide concentra- 
tion at which intoxication begins. It can be seen 
that there was considerable difference of opinion 
as to what constitutes a toxic blood bromide level. 
Most of the determinations were made with some 


table I 

ESTIMATED BLOOD Na Br VALUES AT WHICH 
INTOXICATION BEGINS 


Authority 

Blood 
Serum 
NaBr in 
Mg. Per 
100 cc. 

Number 

of 

Patients 

Observed 

Method of Making 
the Chemical 
Determination 

1 . Claiborne (28) 

200 

1 

Wuth 

2. Harding and Harding (32) 

100 

6 

Wuth 

3. Wagner and Bunbury (20) 

200 

10 

Wuth comparator 

4. Doane and Weiner (33) 

125-150 

4 

Wuth comparator 

5. Ptarris and Hauser (35) . . 

125-150 

12 

Wuth comparator 

6. Wuth (JO) 

125-150 

10 

Wuth 

7. Cross (36) 

150 

5 

Wuth 

8. Tod (19) 

200 

13 

Tod 

9. Preu, et al. (29) 

250 

9 

Wuth 

10. Barbour (22) 

225-250 

6 

Hauptmann modi- 
fication of Walter’s 
method 

11. Sippe and Bostock (25) . .- 

200 

9 

Hauptmann modi- 
fication of Walter’s 
method 

12. Katzenelbogen (27) 

250 

10 

Walter’s 

13. Boshes (37) 

243.4* 

9 

Wuth 

14. Jellinek, et al. (38) 

259** 

80 

Greenberg 


*This is an average figure. 

' **The blood serum bromide figure given by the authors is 200 
milligrams per cent. This has been changed to milligrams of 
sodium bromide per cent to correspond with the other values 
in the table. \ 

modification of the gold bromide technic. As noted 
above, this test is not chemically accurate. With 
the exception of Jellinek, et al.,^* the observed 
number of cases is too small in each instance to 
permit the formation of any sweeping conclusions 
about the blood bromide concentration at which 
intoxication is said to begin. The observations in 
the first nine instances listed were made upon pa- 
tients admitted to the hospital with a clinical diag- 
nosis of bromide intoxication. Therefore, the 
blood bromide levels noted for those patients were, 
of necessity, not the ones present when the symp- 
toms and signs of bromide intoxication appeared. 
The conclusions of Barbour,^^, Sippe and Bos- 
tock,^^ Preu, et al.,^® Katzenelbogen,^’^ and Bosh- 
es'^' were admittedly not final ones, because of the 
general difficulties of conducting an experimental 
study of this type. Recently Jellinek, et al.,®® have 
] ublished “An Experimental Study of Bromism.” 
Quoting from that article, “It may thus be stated 
definitely that in these normal subjects ( they had 
80 of them) at the fairly high serum bromide lev- 
els between 120 and 200 milligrams per 100 cubic 
centimeters, no symptoms occurred which would 
have the slightest resemblance to psychotic mani- 
festations nor were there any neurological signs of 
intoxication.” 

There is considerable difference of opinion be- 
tween various authors as to the symptoms and 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


123 


signs wliich are characteristic of bromide intoxica- 
tion or psychosis. Preu^® found “the early mental 
symptoms of intoxication are an exaggeration of 
the therapeutic sedative effect ; sluggishness of 
thought, speech, and action. Impairment of con- 
sciousness with disorientation and memory defect 
follow, and in severe intoxication delirium may 
occur with delusions and vivid visual and auditory 
hallucinations.” In contrast to this description of 
the syndrome is the multiplicity of signs and symp- 
toms enumerated by Sensenbach® as being charac- 
teristic of bromide intoxication. Mental confu- 
sion, stupor, delusions, headache, hallucinations, 
nervousness, weakness, gait disturbance, coated 
tongue, palpitation, slurred speech, irritability, de- 
pression, dizziness, memory defect, smothering 
spells, insomnia, nausea and vomiting, transitory 
blindness, transitory incontinence, and anorexia 
are listed in the author’s table entitled “Signs and 
Symptoms of Bromide Intoxication.” According 
to Hanes and Yates^^ dull morning headache, con- 
stipation, indigestion, fatigue, irritability, sleep- 
lessness, difficulty in concentrating, poor memory, 
dizziness, unsteady gait, emotional instability, 
weakness, lethargy, slurring speech, irrelevant 
speech, delusions, disorientation, hallucinations, 
cyanosis, vacuous facies, dilated pupils, stupor, 
blurred vision, mental confusion, disordered 
dreams, vertigo, and loss of libido are produced by 
the presence of high concentrations of bromide in 
the body. Apparently, Sensenbach® and Hanes 
and Yates^^ have tabulated all of the symptoms and 
signs of a group of patients allegedly suffering 
from bromide intoxication, and have then con- 
cluded that all of these complaints and physical 
findings were produced by the presence of an ab- 
normal quantity of bromide in the patients’ blood 
serum. The use of such a method to determine the 
symptoms and signs of bromide intoxication only 
leads to additional confusion concerning what 
items are actually a part of this syndrome. Over 
half of the signs and symptoms listed in the two ar- 
ticles cited are among those most often found in the 
clinical picture of psychoneurosis, a condition for 
which bromides are often prescribed. Before cer- 
tain symptoms and signs are ascribed to the inges- 
tion of any drug, it must be shown that they were 
not present before the drug was administered. 

During the past fourteen months we have stud- 
ied the action of sodium bromide by giving it to 
patients in varying quantities for long periods of 
time. Observations have been completed on 36 
patients, all of whom took the medication vol- 
untarily. A detailed account of this work is being 
published in a separate communication. It should 
be noted that the Brodie-Friedman"*^ method was 
used for all of the blood serum bromide determi- 


nations made. The results obtained by this method 
are accurate at all levels, and are expressed in milli- 
grams of liromine per 100 cubic centimeters of 
blood serum. This is in contrast to the various 
modifications of the gold bromide method which 
produce a result read as milligrams of sodium 
bromide per 100 cubic centimeters of blood serum. 
This is an important point, as the “Wuth” figure 
corresponding to a given blood serum bromine 
level by the Brodie-Friedman method would be 
approximately 30 per cent higher. 

We have found that the clinical picture of bro- 
mide intoxication is a simple one. The patient first 
complains of an increased desire for sleep, and 
then begins to take an extra nap whenever he can. 
The need for sleep increases until the patient be- 
gins to fall asleep while reading, or has trouble 
maintaining his attention on uninteresting subjects. 
As the blood serum bromide concentration gradu- 
ally increases, slurring of the speech api>ears. fol- 
lowed in order by the development of a mild stag- 
gering gait. These physical signs gradually pro- 
gress as the intoxication increases, until the patient 
is confined to bed by the severity of the ataxia, 
and the fact that the clouding of consciousness has 
reached the state of stupor. In this stage the pa- 
tient may be disoriented for time because of lack 
of attention. The subject is frequently inconti- 
nent, and may have to be fed — again because of 
the severity of the clouding of consciousness. All 
of these findings were produced by the exagger- 
ated sedative effect of the high blood serum bro- 
mide concentration, and were not present before 
the drug was given to the subjects. 

The clinical syndrome called bromide psychosis 
is also essentially a simple one. (The term “bro- 
mide psychosis” is used advisedly. This condition 
is a toxic psychosis or delirium and, as such, dif- 
fers from a more fundamental type of psychosis 
such as schizophrenia or involutional melancholia. 
A better term would be a “toxic delirium due to 
bromides,” but for the sake of brevity we shall 
continue to refer to the condition as a “bromide 
psychosis.”) Patients having bromide psychosis 
were seen to exhibit the physical findings of bro- 
mide intoxication, plus hallucinations, delusions, 
and disorientation. With the latter three findings 
came the excitement, negativism, and general dis- 
orderly conduct which they commonly produce. 
Dull morning headache (or headache of any kind) , 
constipation, indigestion, sleeplessness, palpitation, 
visual disturbances, irritabilit)^, brown furry coat- 
ing of the tongue, smothering spells, and cyanosis 
have not developed in any of the patients receiv- 
ing bromides. Nausea and vomiting were fre- 
quently observed in this study, but were not a 
part of the syndromes of bromide intoxication or 


124 


Journal of Iowa State Medical Society 


April, 1945 


bromide psychosis. They often occurred the first 
day the drug was given, came on shortly after the 
ingestion of the drug, and were, apparently, pro- 
duced hy the irritating effect of the- sodium bro- 
mide on the gastric mucosa. 

In the entire series of 36 patients studied thus 
far. the lowest blood serum bromide level at which 
the syndrome of bromide intoxication appeared 
was 195 milligrams per cent. 

treatment 

The principal treatment of bromide intoxication 
is to discontinue the drug. The importance of 
maintaining and controlling the sodium chloride 
metabolism has been emphasized by many authors. 
Gray and Moore^^ point out that “Bromides have 
a much higher renal threshold than do chlorides, 
and consequently tend to replace chlorides in the 
tissues, causing the latter to be excreted in the 
urine.” Wagner and Bunbury-^ observed in- 
creased severity of the intoxication when bromides 
were stopped suddenly, and sodium chloride was 
given in large amounts. They attempted to ex- 
plain this phenomenon as a sudden release of bro- 
mides from the tissues by the introduction of chlo- 
rides, so that for a short period of time the amount 
of bromide circulating in the blood was increased 
rather than decreased. We have not been able to 
confirm this observation. The chloride intake 
should be maintained at a minimum of 12 to 15 
grams of sodium chloride per day as long as in- 
toxication persists. It may be necessary to give 
the sodium chloride intravenously, or under the 
skin, in the form of physiologic salt solution. Fif- 
teen hundred to two thousand cubic centimeters of 
this solution daily will supply the needed amount 
of sodium chloride. A moderately increased fluid 
intake aids in the excretion of the bromide by the 
kidneys, and tends to shorten the course of the 
intoxication. Three thousand to four thousand 
cubic centimeters of fluid daily is an adequate 
amount. The limits may be adjusted, depending 
upon the size of the patient. If the patient cannot 
take this amount of fluid by mouth, it must be 
given by some other method. A careful record of 
the daily fluid intake and output should be kept 
in the nurses’ notes. 

Patients having a severe bromide psychosis fre- 
quently are excited and unruly, because of the vivid 
hallucinations and delusions from which they suf- 
fer. Ordinarily, we do not like to restrain such 
patients, since the excitement already present is 
frequently aggravated by such measures. The con- 
tinuous presence of an attendant or graduate nurse 
is a better solution. At times some other medica- 
tion may be needed to quiet the patient so that 
fluids may be administered. We have found that 
20 cubic centimeters of paraldehyde in peanut oil. 


injected rectally, is often effective. In more severe 
cases the intravenous administration of .225 gram 
to .450 gram (depending upon the size and re- 
action of the patient) of a solution of sodium 
amytal is justified. Either amount of the drug can 
be dissolved in ten cubic centimeters of sterile 
water. Craven^^ observed a case in which paralde- 
hyde, sodium amytal, and chloral hydrate increased 
the delirium, rather than quieting it. In our ex- 
perience sodium amytal has been an effective prep- 
aration under these circumstances. ToenharP^ 
recommends gastric lavage, since it is known that 
bromides occur in high concentration in the gastric 
secretion. The danger of aspiration of material 
into the bronchial tree by a stuporous patient seems 
to outweigh the advantages of such a procedure. 

During the period of severe intoxication, care 
must be given to the bladder, bowels, and skin. 
The patient should be turned in bed frequently. 
If there is itching due to the presence of a bro- 
mide eruption, calomine lotion with 1 per cent 
phenol may be applied to the involved areas. 

Should bromide intoxication and cardiac failure 
occur simultaneously in the same patient, ammo- 
nium chloride may be used in place of sodium chlo- 
ride, thus supplying the need for chloride without 
introducing any additional sodium into the system. 

The prognosis of patients having bromide intoxi- 
cation is good for the ultimate return of the patient 
to his pre-bromide ingestion mental state. The 
time usually necessary for this improvement is 
seven to twenty-one days. If the patient continues 
to show abnormal symptoms and signs after 
twenty-one days of bromide elimination therapy, it 
is probable that the abnormalities are due to some- 
thing other than the presence of an unusual amount 
of bromide. A careful review of the patient’s his- 
tory, in such instances, will generally reveal that 
there was some definite organic or psychic pathol- 
ogy present before the administration of bromides. 

summary 

The incidence of bromide intoxication at the 
State University of Iowa Hospitals in the last 
seven years was .048 per cent. This figure is 
lower than most of the few others published in the 
literature. 

The criteria for the diagnosis of bromide intoxi- 
cation and psychosis are reviewed. Many of the 
cases of alleged bromide intoxication reported in 
the literature do not fulfill these criteria. Consid- 
ering the inaccuracies so prevalent in the diagnosis 
of this syndrome, it is evident that we know very 
little about the incidence of bromide intoxication. 

There is difference of opinion about the blood 
serum bromide level at which intoxication begins. 
The lowest blood serum bromide level at which we 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


125 


have observed experimentally produced bromide 
intoxication is 195 milligrams per cent. 

The symptoms and signs which can be ascribed 
to the toxic action of sodium bromide are enu- 
merated. 

The principal points in the treatment of bromide 
intoxication are reviewed. 


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THE VALUE OE TESTING FOR PEN- 
ICILLIN RESISTANCE BEFORE AD- 
MINISTRATION IN CASES OF 
CHRONIC OSTEOMYELITIS 
F. Eberle Thornton, M.D., and 
Albert P. McKee, M.D. 

For the past six or seven months, it has been 
our practice in the Orthopedic Department in cases 
of chronic osteomyelitis to determine before the 
administration of penicillin the possible resistance 
of the patients’ infective organisms to penicillin 
therapy. This has been carried out because of 
information, which reached us from various Army 
and Navy hospitals, of the fact that certain infec- 
tions, which commonly respond to penicillin ther- 
apy, had shown no improvement. It has been 
shown that the organisms of these cases were re- 
sistant to penicillin, and that in such circumstances 
a very valuable and scarce drug was being wasted. 
It is known that small doses of penicillin, when 
administered into cultures of staphylococci and 
streptococci over a period of time, will develop in 
these organisms a resistance to the drug, and that 
the organisms will live in spite of the presence 
of the drug. 

Again we saw cases of chronic osteomyelitis in 
which penicillin was administered and there were 
no visible signs of clinical improvement in the pa- 
tient even though previous penicillin therapy had 
not been instituted. In others, probably an inade- 
quate amount was administered and a resistance 
developed in this manner. Still another possibility 
is that adequate surgical drainage did not accom- 
pany the penicillin therapy. It is known, too, that 
various organisms become resistant to sulfa drugs 
in a similar way. Because of this and the infor- 
mation from various military hospitals, we de- 
cided to test our patients for possible penicillin 
resistance. This was carried out under the super- 
vision of the Bacteriology Department and the 
technic was as follows : 

The test to be described here is a slight modifi- 
cation of the one introduced by Fleming,^ the dis- 
coverer of penicillin. The materials used are sim- 
ple, few in number, and likely to be available in 

From the Departments of Orthopedic Surgery and Bacteriol- 
ogy. 

Acknowledgments are given to William M. Hale, M.D., for 
criticisms of the manuscript and Dr. J. R. Porter for constructing 
the diagrams. 


126 


juruNAL OF Iowa State Medical Society 


April, 1945 


the average liacteriolog}’ laboratory. Blood agar 
plates, a tool for removing disks of agar from the 
plates, penicillin-resistant bacteria, penicillin-sus- 
ceptible bacteria, and the organisms to be tested 
fulfill the imix)rtant requirements for performing 
the test. 

The medium used in this laboratory is 5 per cent 
sheep’s blood infusion agar. The depth of the 
agar in the plate should average about five milli- 
meters for best results. Some instrument is neces- 
sary to cut disks from the agar. In this labora- 
tory we use a sterile cork borer fifteen millimeters 
in diameter. If one uses a punch too small in diam- 
eter, the well left upon removing the agar disk 
will not hold sufficient penicillin to conduct the 
test satisfactorily. Too large a well requires an 
unnecessarily large amount of penicillin. 

To control the penicillin-sensitivity test prop- 
erly, a resistant strain and a susceptible strain of 
bacteria are required in addition to the organism 
to be tested. We use a resistant and a susceptible 
strain of Staphylococcus aureus. These organisms 
are easily maintained on nutrient agar in the re- 
frigerator when transferred every two or three 



FIG. I. SHOWING METHOD OF INOCULATION AND GROWTH 
OF ORGANISMS IN THE PRESENCE OF PENICILLIN. 
numbers IN SMALL CIRCLES INDICATE THE UNITS OF 
PENICILLIN ADDED PER CUP. 

weeks. Occasionally we have run the test using 
the exudate containing the organism under inves- 
tigation directly. Usually it is more satisfactory 
to isolate it in pure culture first and then proceed 
with the examination. 

Very small quantities of penicillin are necessary 
in this test. We obtain our penicillin from the 
clinician desiring to learn the penicillin-sensitivity 
status of the organism with which he is about to 
cope. The dilutions are made in sterile 0.9 per 
cent sodium chloride so that 0.1 milliliter of one 
dilution will contain ten units and 0.1 milliliter 
of a second dilution will contain one unit. Our 
stock penicillin is stored in the refrigerator at 4° 
centigrade. If strict asepsis is followed in han- 
dling penicillin, it can be kept for at least six to 
eight weeks. It may seem paradoxical to use strict 
asepsis in handling a potent antibiotic like penicil- 


lin, but such is necessary. Certain bacteria, nat- 
urally resistant to jx'uicillin, can destroy the drug 
very rapidly, hence asepsis is paramount in han- 
dling it. 

With the above materials available the sensitiv- 
ity test is easy to perform. Two disks are cut from 
each blood agar plate with the sterile cork borer 
in the areas indicated by figure 1. One plate is 
inoculated with the penicillin-resistant organism 
streaking from the outer edge of the agar in to 
the edge of one of the holes. This procedure is 
repeated on the other side of the same hole. Now 
inoculations are made on either side of the second 
hole of the same plate. Note the direction of the 
inoculation as demonstrated in figure 1. The 
whole procedure is repeated on the other two plates 
using a penicillin-susceptible strain on one and 
the test organism on the other. 

After the plates are inoculated, ten units of peni- 
cillin contained in 0.1 milliliter are pipetted into 
one hole of each plate and one unit contained in 
0.1 milliliter into the second hole of each plate. 
The plates are incubated lid-side up at the appro- 
priate temperature and oxygen tension required 
by the organisms under investigation. In the 
case of most staphylococci this would be aerobi- 
cally at 37° centigrade. The results are read the 
following day. 

The control plates are read first to be sure the 
penicillin is appropriately inhibitory in action. 
The penicillin-resistant organisms should grow 
right up to the edge of the holes containing peni- 
cillin. The penicillin-susceptible bacteria should 
show a zone of inhibition depending upon its rela- 
tive susceptibility. Our strains of staphylococci 
have been constant in this respect. If the penicil- 
lin has deteriorated on standing, the penicillin-sus- 
ceptible strain will also grow right up to the edge 
of the hole containing the penicillin and a fresh 
sample of the drug must be used to run the test. 

If the controls are acceptable, then the plate 
inoculated with the test organism may be read. The 
use of two concentrations of penicillin permits 
some spread in estimating the sensitivity of the test 
organism. Our own experience has been very 
clear-cut in that the test organisms either have 
been obviously susceptible to both dilutions or 
resistant to both. The line of demarcation, that 
is, where the organism ceases to grow, is almost 
always sharp. See figure 1 for illustration of 
typical results of the test when a penicillin-sus- 
ceptible test organism is encountered. 

The sensitivity test described above, when prop- 
erly controlled and used with good Judgment, is 
quite reliable. We have used the same test for 
organisms other than staphylococci, such as beta- 
hemolytic streptococci, pneumococci, and alpha- 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


127 


hemolytic streptococci, with eeinally satisfactory 
results. 

W'e have used this method of testing for re- 
sistance only in cases of chronic osteomyelitis, 
since in a good share of the cases of acute osteo- 
myelitis, penicillin therapy is started before it is 
possible to obtain a culture of the type of organism. 

Up to the present time, nine patients have been 
tested for resistance to penicillin therapy. None of 
these patients was given the drug, since we be- 
lieved w*e would be wasting a valuable and precious 
drug under the present circumstances of war. 
However, one patient vrent elsewhere and obtained 
what normally would be considered an ample 
course of penicillin therapy with no clinical im- 
provement. This one case has not proved our 
point, but it certainly has helped to substantiate 
our belief and others, that it is of no clinical value 
to give patients penicillin under these circum- 
stances. We believe that with the scarcity of this 
spectacular drug it should be given only to those 
patients with chronic osteomyelitis whose organ- 
isms are susceptible to the drug. 

The purpose of this paper is to show that peni- 
cillin should not be given in all cases of chronic 
osteomyelitis, and that we are probably wasting 
penicillin in cases which show resistance on lab- 
oratory tests, particularly when in these times the 
drug is so important. 

At the present time, then, the drug should be 
used in those cases of chronic osteomyelitis in 
which the organisms are resistant and in the acute 
cases of osteomyelitis, and in conjunction with ade- 
quate surgical drainage. With the same token, we 
may not in turn disillusion some of these patients 
who have had a chronic osteomyelitis for years and 
who expect the wonder drug, penicillin, to give 
them the cure they have for so long been seeking. 
reference 

1. Fleming:, A. : In-vitro tests of penicillin potency. Lancet 
i:73?-733 (June 20) 1942. 


AIENINGITIS AND OTHER INFECTIONS 
CAUSED BY HEMOPHILUS INFLU- 
ENZAE (PFEIFFER’S BACILLUS) 
Hunter H. Comly, M.D., and 
Albert P. McKee, iM.D. 

clinical aspects of infections caused by 
HEMOPHILUS influenzae 
Since February, 1938, seventeen patients with 
influenzal meningitis have been treated in the State 
University of Iowa Hospital. In May, 1943, the 
mode of treatment was revised. Since February, 

From the Departments of Pediatrics and Bacteriology. 

The authors wish to express their gratitude for the helpful 
criticism offered by Julian D. Boyd, M.D., Professor of Pediatrics, 
and William M. Hale, M.D., Professor and Head of the Department 
of Bacteriology, both in the College of Medicine, State University 
of Iowa. 


1943, eleven patients have been treated with sulfon- 
amide drugs. There were eight deaths, two recov- 
eries, and one case which resulted in hydroceph- 
alus and idiocy. From May. 1944, to February, 
1945, six similar patients have been treated with a 
combination of sulfonamides and type-specific 
rabbit antiserum. The first patient died ; the other 
five were discharged as cured without residual 
damage. 

Each patient served to illustrate important as- 
pects of the problem of infection in childhood 
caused by Hemophilus influenzae (Pfeififer’s ba- 
cillus). An attempt will be made in this report to 
review the essential features of these infections 
and outline the present therapeutic and bacterio- 
logic routine. 

In interepidemic periods meningitis due to influ- 
enzae, pneumococci, and meningococci occurs in 
infants and young children with approximately 
equal frequency.^ This fact has been stressed by 
Alexander and is borne out by the experience in 
this hospital. 

Penicillin is ineffective in infections caused by 
H. influenzae. One patient treated with sulfadia- 
zine plus intrathecal and intramuscular penicillin 
in another hospital progressed to untreatable chron- 
icity and died in this hospital despite rabbit anti- 
serum therapy. 

The occurrence or suspicion of meningitis, there- 
fore, calls for the immediate bacteriologic identi- 
fication of the causative agent. The recognition of 
meningitis in infants under one year of age is 
particularly difficult. The peculiar pathogenicity 
of the H. influenzae bacillus makes it doubly so. 
The onset of meningococcal meningitis is apt to be 
fulminating and the alarming picture presented 
immediately calls to mind the possibility of menin- 
gitis. Petechiae tend to confirm the suspicion. On 
the other hand, pneumococcic and particularly 
Hemophilus influenzal meningitis is likely to be in- 
sidious in onset. Frequently infants show only 
fever or irritability, food refusal or drowsiness to 
indicate that all is not well. A baby with an open 
fontanelle may have widespread meningeal infec- 
tion without a stiff neck or bulging fontanelle to 
warn the clinician. Too frequently in our series the 
infant had a fever of undetermined origin for sev- 
eral days before' a diagnosis was made. The un- 
pardonable negligence of failing to examine the 
spinal fluid after a so-called “febrile convulsion” 
has led to- the postponement of diagnosis and 
treatment by days or weeks in some cases. 

Although the spinal cord extends one lumbar 
space lower than in adults, the technic of the lum- 
bar puncture in infants and children is not differ- 
ent than in adults. Usually the procedure is much 
easier. In the presence of a spinal fluid block. 


128 


Journal or Iowa State MEDicAr. Society 


April, 1945 


epidural hemorrhaf^e, or marked dehydration, the 
puncture may not yield fluid. Such an eventuality 
calls for cisternal or ventricular puncture in order 
to obtain a sample of fluid for quantitative sugar 
determination, cell count, smear, and culture. Fre- 
quently septicemia coexists. Hence, in every case 
of suspected meningitis a blood culture should be 
obtained. The infective agent may be identified 
from the blood culture alone or before the spinal 
fluid cultures grow out. Nasopharyngeal cultures 
are helpful. 

The type b. Flemophilus influenzae organism has 
a predilection for certain sites and organs in the 
human infant. Alexander has stressed the fact 
that the three common eventualities of infection 
with this organism in infancy are meningitis, ob- 
structive epiglottitis and pneumonia with empy- 
ema.^ Suppurative otitis media and 'mastoiditis 
may accompany, precede, or follow the other com- 
plexes. Two patients in our series illustrate these 
aspects vividly. 

P. S., months of age, was admitted to an- 
other hospital with pneumonia and empyema. Two 
weeks after the onset a rib resection was per- 
formed. Nineteen days after the onset bilateral 
mastoidectomies were done. Five days later 
Hemophilus influenzae was cultured from the spi- 
nal fluid. Despite intrathecal sulfonamides the 
baby died on the fortieth day of the disease. 

B. W., years of age, was well except for a 
mild cold until 5 :30 a. m. October 14, 1944, when 
he became restless and seemed feverish. By 8:00 
a. m. he seemed to be having difficulty in breath- 
ing and he made a crowing inspiratory noise. He 
rapidly became cyanotic. When his mother tried 
to comfort and aid him, he suddenly “choked up” 
and died. An autopsy was performed elsewhere 
but the neck structures were not examined. Nev- 
ertheless, the rapid progress of the symptoms, the 
croupy respirations and the sudden death when 
stimulated all suggest a clear-cut clinical entity. 
The history is virtually diagnostic of Hemophilus 
influenzae, type b, epiglottitis or so-called “flu 
croup.” The only thing that could have saved this 
child was immediate tracheotomy. Forty-eight 
hours later a sibling 18 months of age was admitted 
to our hospital because of convulsions. The diag- 
nosis of influenzal meningitis was suspected from 
the history and this was confirmed by the bacteriol- 
ogists. The child was successfully treated in ac- 
cordance with the following method : 

When a child suspected of having meningitis is 
admitted, a lumbar puncture is done immediately 
and the blood and nasopharynx are cultured. The 
spinal fluid is collected in three separate tubes, one 
for bacteriologic examination, one for determina- 
tion of dextrose and protein content, and one for 


study of the cytology. Should purulent fluid be 
obtained, the child immediately is given a subcu- 
taneous injection of sodium sulfadiazine in a 5 
per cent solution in the dosage of 0.75 grain per 
pound of body weight. While awaiting the lab- 
oratory data an intravenous infusion of 5 per cent 
dextrose is begun. If the child is dehydrated an 
amount of norma! saline calculated to re-establish 
hydration is given intravenously or subcutaneously,^ 
It is expected that in four to five hours about 20 
cubic centimeters of dextrose solution per pound 
of body weight will have run in. If the type b 
Hemophilus influenzae oi'ganism is identified, type- 
specific rabbit antiserum is obtained. The patient 
is tested for hypersensitivity to rabbit serum by 
injecting 0.1 cubic centimeter of a 1:100 dilution 
of the therapeutic serum intracutaneously and 
placing 1 drop of the diluted serum in the con- 
junctival sac and waiting forty-five minutes. If 
no signs of sensitivity are elicited, it is considered 
safe to give the serum. When the glucose infu- 
sion is complete, the dosage of serum calculated 
according to Alexander’s schedule is dissolved in 
100 cubic centimeters of saline and added to the 
reservoir and allowed to run in slowly. The glu- 
cose infusion is necessary for it tends to wash out 
circulating specific soluble carbohydrate which has 
been excreted by the organism. Removal of the 
carbohydrate frees more serum so that it may unite 
with more such carbohydrate in the organism’s cap- 
sules and aid in producing bacteriostasis.^ Two 
hours following completion of the therapeutic 
serum infusion, a sample of the patient’s blood is 
withdrawn and centrifuged. The patient’s serum 
so obtained is diluted with 9 parts of saline and 
is tested for its ability to cause capsular swelling of 
the patient’s organism. If such “quellung” oc- 
curs, the dose is considered to have been sufficient. 
If the capsular swelling does not occur, another 
ampule of serum is given and the test is repeated. 
Usually, if adequate serum is on hand, the dosage 
provided by Alexander’s schedule^ is all that is 
necessaiy. Because of the scarcity of this expen- 
sive agent it may be necessary to give more than 
the initial ideal dose in divided amounts as it be- 
comes available. In one such case only one-fourth 
of the necessary serum was obtainable immediate- 
ly. It seemed logical to modify the routine and 
give the first dose of serum intrathecally, hoping to 
effect a higher concentration about the meninges. 

The dose of antiserum is based on the fact that 
the severity of the infection tends to be reflected in 
the reduction of the level of dextrose in the spinal 
fluid. The dose varies inversely with the dextrose 
content. It is very important, therefore, that suffi- 
cient fluid be obtained to make this determination. 
The fluid must be obtained before intravenous 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


129 


solutions are given or the value will not be reli- 
able. Analysis for dextrose must be made imme- 
diately because glycolysis proceeds rapidly in the 
presence of pus and bacteria. The schedule of 
dosage as given by Alexander is included in every 
package of the antiserum, but more serum must 
be given if “quellung” with the diluted serum does 
not occur. In other infections with the organism 
this criterion alone must be used as a measure of 
adequate therapy. 

A blood level of sulfadiazine ranging between 
15 and 20 milligrams per 100 cubic centimeters is 
maintained for one week after sterile spinal fluid 
cultures are obtained. If in forty-eight hours the 
response is not favorable and the dosage has been 
satisfactory, 1 ampule of serum is given intra- 
thecally. 

Other sites of possible infection are watched 
closely. Smouldering mastoiditis is not uncom- 
mon. If its presence is suspected, a simple mastoid 
antrotomy should be done so that the pus will drain 
and not “feed” the meninges. 

Minor toxic states such as rashes or crystalluria 
should not be given undue weight. If a typical 
toxic erythema occurs, the sulfonamide should be 
changed. Simple miliaria must not be so misin- 
terpreted. Extra fluid may be given by gavage, 
hypodermoclysis, or infusion. 

An optimistic attitude toward the treatment of 
meningitis of fairly long standing should prevail. 
Alexander recently has cited recovery in babies 
suffering for six or seven weeks with spasticity, 
strabismus, nystagmus and other signs of severe 
damage.^ Infants and children have remarkable 
powers of recovery, and this fact should not be 
forgotten in their treatment. 

BACTERIOLOGIC AND SEROLOGIC ASPECTS OF 
INFECTIONS CAUSED BY HEMOPHILUS 
INFLUENZAE 

Hemophilus influenzae was first isolated by 
Pfeiffer in 1889. Until recently this bacterium 
was considered by many investigators to be the 
cause of clinical influenza and was so named. Dur- 
ing past epidemics of clinical influenza it was not 
uncommonly isolated from patients who had a 
bacterial pneumonia superimposed upon what is 
now believed to have been a virus infection. iMore 
recent investigations leave no room for doubt that 
clinical influenza, as we now see it, is caused by a 
filtrable virus. ^ Nevertheless the bacterium re- 
tains its misleading species name. 

That H. influenzae may have been misnamed 
and proved not to be the cause of clinical influ- 
enza makes it no less a formidable pathogen. In 
interepidemic periods it has been reported as caus- 
ing as many cases of meningitis as the meningo- 


coccus.^ A review of our own records shows our 
experiences to be in accord with these reports. 

Pittman’s investigations'^ in 1931 laid the basis 
for specific serum therapy of influenzal meningi- 
tis. This investigator noted the differences be- 
tween Hemophilus organisms cultured from nor- 
mal throats and those obtained from pathologic 
sources. She demonstrated a capsule on the patho- 
genic strains and found such a capsule to be lacking 
among the nonpathogenic strains. She extended 
her work to demonstrate that the pathogenic 
strains of H. influenzae could be divided into six 
types on the basis of the antigenic differences 
among their capsules. The types were designated 
a, b, c, d, e, and f. Since this time, additional 
types have been discovered.*’ The number of types 
encountered to date are not at all as numerous as 
the types found among the pneumococci. Fortu- 
nately, from the bacteriologist’s point of view, the 
vast majority of human infections are caused by 
type b. 

Careful studies of the antigenic structure of cap- 
sule-forming strains of H. influenzae and the re- 
sponse of experimental infections caused by this 
organism to specific serum therapy^ led to some 
worthwhile deductions. Alexander, et al.,^ noted 
the very close similarity between work done in the 
past on the pneumococcus and the results they 
obtained in their studies of H. influenzae. These 
experimenters were quick to capitalize on these 
similarities. 

The results of this fundamental variety of ex- 
perimental endeavor permitted the following con- 
clusions : (1) Pathogenic strains of H. influenzae 
are encapsulated with a polysaccharide substance. 
(2) It is this polysaccharide capsule that deter- 
mines the type specificity of the strain. (3) Intel- 
ligent serum therapy must take cognizance of the 
antigenic type of the organism. (4) The severity 
of the infection is closely paralleled by the amount 
of type-specific capsular polysaccharides found in 
the blood stream and body fluids during an infec- 
tion. (5) A slight excess to the quantity of type- 
specific antibody required to tie up all of the cap- 
sular polysaccharides in a given case is assumed 
to be necessary for successful serum therapy. (6) 
A combination of sulfonamide and specific serum 
therapy gives better therapeutic results in H. in- 
fluenzae infections than either one alone in both 
experimental and human infections. (7) The ear- 
lier the treatment is started, the better the pa- 
tient’s chance of survival. (S) H. influenzae 
meningitis is not a characteristic clinical entity and 
therefore must be diagnosed bacteriologically. (9) 
Other H. influenzae infections are finally diag- 
nosed bacteriologically. 

In the light of what has gone before, then, the 


130 


jointNAL OF Iowa State Medical Society 


April. 1945 


hactCM'iolog'ist’s obligations lieconie apparent: (1) 
Establish an earh- and accurate diagnosis of the 
type of H. influenzae causing the infection. (2) 
Determine the adequacy of specific serum therapy. 
Both of these services can be rendered in any lab- 
oratory competent to type pneumococci. 

The bacteriologist’s duties begin with the receipt 
of a satisfactory specimen from the cases of sus- 
pected H. influenzae infection. Such specimens 
may include spinal fluid, blood cultures, mucus 
from the upper respiratory tract, and pus from 
various pyogenic processes. Examination of 
smears, stained by Gram’s method, from spinal 
fluid, mucus, or pus may well show the presence 
of gram-negative, small, coccohacillary forms and 
some filaments. The presence of this somewhat 
characteristic morphology permits one ^to proceed 
with the “Neufeld-quellung” typing technic. A 
loopful of the exudate is added to each loopful of 
the various typing sera. Enough methylene blue 
is added to color the organisms. After a few min- 
utes have elapsed, the preparation may be examined 
with the microscope, using the high power objec- 
tive and the oil immersion objective. Homologous 
antigen-antibody mixtures result in a swelling of 
the bacterial capsule, and microscopic agglutination 
is usually also present. One should not consider 
the results of the typing negative until after the 
preparation has stood thirty minutes and still no 
capsular swelling has occurred. 

It is obvious that the technic for typing H. 
influenzae is identical with that used in typing 
Diplococcus pneumoniae and equally simple. It 
is only fair to mention that the capsular swelling 
occurring when the test is applied to H. influenzae 
is not as sharp and distinct as results obtained with 
most pneumococci. However, by using heterolo- 
gous controls and known positives one needs very 
little practice to be able to type the Hemophilus 
organisms quickly and accurately. 

The specific polysaccharide substance may be 
typed directly from the spinal fluid by tbe use of 
the precipitin test. After centrifuging the spinal 
fluid the supernatant portion is layered over the 
type-specific antisera. The appearance of a pre- 
cipitate at the interface denotes a homologous type. 
Such a procedure requires more antibody than the 
“Neufeld-quellung” procedure and is therefore 
more expensive. In addition considerable time 
UiUSt have elapsed in the course of the disease 
before sufficient polysaccharide is present in the 
spinal fluid to permit typing by this method. 

Occasionally a spinal fluid will be drawn so early 
in the course of a meningitis that the organisms 
will be so few as to make direct typing difficult or 
impossible. Another example in which typing 
directly may be necessarily postponed is encoun- 


tere<l when attempting to tyjie H. influenzae from 
pus or mucus, when many other organisms are 
present. In either case culturing the organism on 
artificial culture media is necessary as a prelimi- 
nary step. Spinal fluid may be plated directly on 
chocolate agar and the organisms tyjied from the 
colonies. Usually this means a delay of about 
twelve hours. Not uncommonly spinal taps that 
are clear and contain very few organisms when 
first drawn may be cloudy and contain numerous 
bacteria when repeated in three or four hours. 
Direct typing may he performed on the second 
specimen and a diagnosis be made before the cul- 
ture plates have grown out. 

When a specimen of exudate contains a mixed 
flora and one is unable to type the Hemophilus 
organisms directly, there is no alternative other 
than culturing the specimen on artificial culture 
media. Most organisms found in conjunction with 
H. influenzae are more prolific in their growth on 
culture media than H. influenzae and tend to over- 
grow it. In addition to this some species of cocci 
actually produce inhibitory substances that prevent 
the growth of H. influenzae on the same plate. 
The number of successful isolations of the organ- 
ism in question may be considerably increased by 
the use of special technics. 

Taking advantage of the fact that H. influenzae 
is not inhibited in its growth by penicillin and that 
most cocci are so inhibited, Fleming® was able to 
culture H. influenzae from numerous throats 
whereas without this special technic he often 
failed. 

Two or three drops of penicillin solution (about 
10 units per milliliter) are spread about the sur- 
face of a chocolate agar plate with a glass spreader. 
The specimen to be cultured is then inoculated on 
the plate using a rather heavy inoculum. Usually 
one may type the organisms from the colonies in 
twelve hours. One must remember that such a 
procedure will also cause any rough strains of 
H. influenzae to be cultured and that these will 
not type since they possess no typeable capsule. 
The rough strains are considered to be weakly, if 
at all, pathogenic. However, experimental investi- 
gation leads one to believe that partially rough 
strains may under adequate provocation become 
fully encapsulated and smooth.® 

Blood cultures require special consideration. 
Statistical evidence leaves little doubt that most 
cases of meningitis caused by H. influenzae are 
accompanied by or preceded by a _ bacteremia. 
Respiratory tract infections caused by H. influ- 
enzae such as laryngotracheitis, laryngotracheo- 
bronchitis. and epiglottitis, are almost without ex- 
ception accompanied by blood stream invasion. 
After about twenty-four hours of incubation, a 


VoL. XXXV, No. 4 


131 


Journal of Iowa State Medical Society 


portion of the blood culture should be centrifuged 
for examination. The sediment may be smeared 
and stained by Gram’s stain. If suspicious organ- 
isms are found, typing should be carried out. If 
the morphologic and serologic examinations of the 
sediment yield uncertain or negative results, the 
sediment should be cultured on chocolate agar. 

Special isolation practices are not required for 
examination of blood and spinal fluids for they 
practically always yield pure cultures. Since H. 
influenzae grows very poorly, if at all, on nutrient 
agar slants, particularly when freshly isolated, it 
is a good practice to inoculate one of these slants 
to aid in dififerentiating organisms which may be 
morphologically and culturally confused with it. 

It is well to remember that the three organisms 
most commonly causing acute meningitis, Neis- 
seria intracellularis (meningococcus). Hemophilus 
influenzae (influenza-bacillus) and Diplococcus 
pneumoniae (pneumococcus), are morphologically 
dissimilar. Neisseria intracellularis is a Gram- 
negative diplococcus. Hemophilus influenzae a 
Gram-negative coccobacillus accompanied by a 
varying number of long filaments, and Diplococcus 
pneumoniae a Gram-positive diplococcus. In ad- 
dition to these morphologic differences, each of 
these organisms may be studied directly by sero- 
logic methods since specific diagnostic rabbit anti- 
sera may be obtained against each. Not uncom- 
monly one may examine a very cloudy spinal fluid 
in which apparently no bacteria are to be found. 
As a result of the recorded experiences of others 
and our own experiences we have come to assume 
that if cultivable bacteria be present, almost with- 
out exception meningococci will be cultured from 
such a specimen. 

To expect the serologic diagnosis of H. influ- 
enzae to be without flaw and to anticipate that 
such a test would always be infallible would be 
to expect too much. In those cases in which the 
“Neufeld-quellung” typing gives equivocal results 
or fails entirely to type the organism, one should 
fall back on a cultural diagnosis of the organism. 
In addition to the above situation it is a good pro- 
cedure to check one’s serologic diagnosis culturally 
no matter how clear-cut the typing may be. Two 
approaches to the same problem with compatible 
results reached by both leaves a greater feeling of 
certainty than relying on any one test. 

On chocolate agar after twenty-four hours, H. 
influenzae produces a round, medium convex, 
semi-opaque, somewhat grayish colony of about 
one millimeter in diameter. A Gram’s stain of the 
bacteria from such a colony shows very small. 
Gram-negative, coccobacillary forms predominat- 
ing the picture. Varying numbers of slender fila- 
mentous forms are also encountered. Many more 


filaments are encountered among the rough forms 
of the organism but a sufficient number occur in 
the smooth colonies to be readily found. 

The fact that H. influenzae requires both the 
“X” factor (an organic iron porphyrine com- 
pound) and the “V” factor, which appears to be 
a di- or tri- phosphopyridine nucleotide (co-enzyme 
I or II) for growth, aids considerably in the cul- 
tural diagnosis of this organism. 

If nutrient agar, ascitic fluid agar, and blood 
agar be inoculated with H. influenzae, this organ- 
ism grows only on the blood agar. Blood contains 
both the “X” and the “V” factor. H. para-influ- 
enzae, an uncommon cause of meningitis, will 
grow on both the blood and ascitic fluid agar since 
it requires only the “V” factor. H. pertussis, 
which is included in the Hemophilus genus will 
grow on all three slants since it requires neither 
the “X” nor the “V” factor. The use of the media 
mentioned illustrates how certain members of the 
genus Hemophilus may be differentiated on the 
basis of their growth factor requirements. 

The effect of an increased amount of “V” factor 
on the growth of H. influenzae may be illustrated 
by use of the “satellite phenomenon.” This is ac- 
complished by spreading a suspension of the or- 
ganism over the surface of a blood agar plate with 
a glass spreader. Following this manipulation a 
culture of Staphylococcus aureus known to syn- 
thesize the “V” factor is inoculated on one or two 
small areas of the plate. After twenty-four hours 
of incubation the colonies of H. influenzae in close 
proximity to the Staphylococcus colonies are very 
much larger than those located some distance away. 
This test may be performed using the spinal fluid 
as a source of the suspension of organisms under 
investigation. 

While the morphologic and cultural examination 
may afford one reasonable assurance of a correct 
diagnosis, it is a good practice to check such an 
organism serologically, that is, with the aggluti- 
nation or “Neufeld-quellung” tests using type- 
specific rabbit antiserum. 

After the bacteriologic diagnosis has been es- 
tablished and specific antiserum administered, the 
clinician may be interested to learn whether or not 
he has given an adequate amount of antibody. 
Alexander^ has determined adequate antibody ad- 
ministration, somewhat arbitrarily, on the basis 
of the serologic response of the patient’s serum 
following the administration of the type-specific 
antiserum. The test she describes is not difficult 
to perform. It consists of mixing a 1 :10 dilution 
of the patient’s serum with a suspension of smooth, 
encapsulated H. influenzae and observing micro- 
scopically for an apparent capsular swelling. 
Enough methylene blue should be added to the 


132 


Journal of Iowa State Medical Society 


April, 1945 


serum-bacterial mixture to color the bacterial cells. 
When capsular swelling occurs with a 1 :10 dilu- 
tion of the patient’s serum, antibody administration 
is considered adequate. When sufficient antiliody 
is administered intravenously, the patient’s serum 
may cause the positive “Neufeld-quellung” reac- 
tion to occur within an hour. 

The intracutaneous test also has been suggested 
as a test for adequate serum therapy. Fundament- 
ally this test is the same as the Francis^** test 
devised for recognizing adequate serum therapy 
for pneumococcal lobar pneumonia. The test con- 
sists of injecting 0.1 milliliter of a solution of type- 
specific polysaccharides intracutaneously in the 
flexor surface of the forearm. An allergic mani- 
festation becomes apparent at the site of the in- 
oculation usually within fifteen to thirty minutes 
if adequate antibody has been administered. 

Some clinicians^^ have treated FI. influenzae 
meningitis by intramuscular injections of antibody 
using a single injection of 75 milligrams of anti- 
body nitrogen. They found the “Neufeld-quel- 
lung” test, using the patient’s serum, to be posi- 
tive in anywhere from one to twelve hours. Ap- 
parently the route of administration affects the 
rate of absorption and consequently the time re- 
quired to reach an adequate antibody level. These 
same investigators obtained positive serum tests 
from six to sixteen days following intramuscular 
administration of the antibody. These results lead 
one to believe that an adequate dose of antibody 
administered all at once certainly may accomplish 
two desirable results; namely, to obtain an ade- 
quate level of antibody in the patient and to have 
a demonstrable quantity of antibody remain for a 
sufficient period of time. It is not for the bac- 
teriologist to settle the questions concerning meth- 
ods and amounts of antibody administration. One 
cannot help but raise the question, however, as to 
whether it would not be a good practice to give 
sufficient antibody from the outset that would be 
sure to be adequate. There is very little, if any, 
sound evidence to support the belief that an exces- 
sive amount of antibody, per se, will be deleterious 
to the patient’s welfare. 

Attempts have been made serologically to esti- 
mate what would be an adequate dose of antibody 
prior to administration.^ As yet the originators 
of the method have been reluctant to place too 
much faith in the test. 

SUMMARY 

1. Since February, 1938, 17 patients suffering 
from meningitis caused by H. influenzae have 
been treated. In the past nine months the mortal- 
ity has been markedly reduced by a combination 
of sulfonamides and type-specific rabbit antiserum. 

2. H. influenzae is a frequent cause of menin- 


gitis in infancy. Accurate bacteriologic diagnosis 
is imperative, since a highly specialized form of 
treatment must be used to assure good results. 

3. FI. influenzae causes other severe infections 
in childhood and similar special treatment is neces- 
sary. 

4. FT. influenzae may be typed quickly and ac- 
curately by tbe “Neufeld-quellung” procedure. 

5. Such typing may be accomplished liy any lab- 
oi'atory competent to type pneumococci. 

6. Adequacy of serum therapy may be checked 
serologically by using the patient’s serum and a 
suspension of encapsulated FI. influenzae. 

BIBLIOGRAPHY 

1. Fothergill, L. D. : Hemophilus influenzae (Pfeiffer bacillus) 
meningitis and its specific treatment. New England J. Med., 
ccxvi :587-690 (April 8) 1937. 

2. Alexander, H. E., Ellis, C., and Leidy, G. : Treatment of 
type-specific Hemophilus influenzae infections in infancy and child- 
hood. J. Pediat., xx:673-698 (June) 1942. 

3. Alexander, H. E. : Treatment of type b. H. influenzal men- 
ingitis. J. Pediat., xxv:517-B32 (December) 1944. 

4. Smith, W., Andrewes, C. H., and Laidlaw, P. P. : Virus ob- 
tained from influenza patients. Lancet, ii:66-68 (July 8) 1933. 

5. Pittman, M. J. : Variation and type specificity in bacterial 
species Hemophilus influenzae. J. Exper. Med., liii:471-492 (April) 

1931. 

6. Gordon, J., Woodcock, H. E. de C., and Zinnemann, K. : 
Meningitis due to Pittman and non-Pittman strains of H. influ- 
enzae. Brit. Med. Jour., i:779-781 (June 10) 1944. 

7. Alexander, H. E., Ellis, C., and Leidy, G. : Treatment of 
type-specific Haemophilus influenzae infections in infancy and 
childhood. Am. J. Dis. Child., lxiv:386-389 (June) 1942. 

8. Fleming, A. : On antibacterial action of cultures of penicil- 
lium, with special reference to their use in isolation of B. influ- 
enzae. Brit. J. Exper. Path., x:226-236 (June) 1929. 

9. Dochez, A. R., Mills, K. C., and Kneeland, Y., Jr.: Varia- 

tion of H. influenzae during acute respiratory infection in chim- 
panzee. Proc. Soc. Exper. Biol. & Med., xxx:314-316 (December) 

1932. 

10. Francis, T., Jr. : Value of skin test with type-specific cap- 
sular polysaccharide in serum treatment of type I pneumococcus 
pneumonia. J. Exper. Med., lvii:617-631 (April) 1933. 

11. Boisvert, P. L., Fousek, M. D., and Grossman, M. F. : Intra- 
muscular administration of anti-Haemophilus influenzae, type B, 
Rabbit Serum ; report of its use in 3 cases of influenzal meningi- 
tis. J. A. M. A., cxxiv :220-222 (January 22) 1944. 


MALARIA AND ITS DIAGNOSIS 
Irving FI. Sorts, M.D. 

Malaria, frequently referred to as “The Scourge 
of the Tropics,” is without question the most prev- 
alent and important disease in the world today. 

In a study reported by the Health Organization 
of the League of Nations in 1932, there were 
17,750,760 cases of malaria treated in sixty-five 
countries in the year this particular study was con- 
ducted. India, which has a population of 350 
million, has 100 million cases annually. In areas 
such as the Malay States, as high as 60 per cent 
of all diseases treated in hospitals and dispensaries 
were due to malaria. 

The mosquitoes of the anopheline genus are re- 
sponsible for the transfer of malaria from man to 
man. Certain species of this genus are distributed 
throughout the United States, A. quadrimaculatus 
and A. punctipennis being most common. A sur- 
vey of mosquitoes in Iowa conducted by J. A. 
Rowe,^ Entomologist, Iowa State College, during 


From the State Hygienic Laboratory, Iowa City. 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society. 


133 


the period from 1936 to 1940, reA^ealed four spe- 
cies capable of carrying and transmitting malaria. 
Anopheles punctipennis was found in 68 of 96 
counties studied. A. quadrimaculatus was found 
in 24 counties, walkeri in 8, and A. maculipen- 
nis in 7. Thus, with an abundance of mosquitoes 
in Iowa capable of transmitting malaria, the intro- 
duction of unrecognized human cases and carriers 
may lead to epidemics of the disease. The prompt- 
ness with which these cases are recognized and 
treated will determine to a considerable extent the 
amount of malaria which will be encountered in 
our state. 

Malaria was highly endemic in the entire upper 
Mississippi River and its tributaries in the pioneer 
days. Petersen- in his recordings of pioneer 
events in Iowa, leaves little question as to the 
great suffering caused by malaria in those early 
days. 

Four species of malarial parasites (plasmodia) 
are transferred to man under natural conditions 
by the bite of infected mosquitoes of the anophe- 
line genus. They are in order of frequency, P. 
vivax (tertian or benign tertian), P. falciparum 
(malignant tertian, subtertian, estivo-autumnal), 
P. malariae (quartan) and P. ovale. The latter is 
primarily limited to Africa and has never been 
observed in the United States. P. vivax is noted 
for its high relapse rate in infected persons ; four 
to six relapses are not uncommon. On the other 
hand, P. falciparum is noted for its pernicious 
attacks which may quickly prove fatal if it is not 
promptly diagnosed and the patient wisely treated. 
Among malarial infections, P. falciparum is known 
as the “killer” because of the high mortality rate. 

If one should look at the world map prepared 
by the United States Army in 1942^ showing the 
distribution of malaria, the disease predominates 
in tropical and subtropical climates. The most 
highly endemic areas are noted in Equatorial 
Africa; all of southern Asia, southern Europe, 
particularly Italy and the Balkans ; the Malay 
Archipelago ; many of the Southwest Pacific Is- 
lands ; Equatorial and Central America. Areas of 
low to moderate endemicity, are the southern part 
of the United States and the entire southern part 
of the Soviet Union. It is interesting to note that 
Italy and the Balkan States in general, which oc= 
cupy a similar latitude to Iowa, comprise a highly 
endemic malarious area, while malaria in Iowa is 
very sporadic in occurrence. The question arises 
as to why the entire southern portion of the Soviet 
Pbiion is a moderate to low endemic area while 
corresponding areas in the northern United States 
and southern Canada are relatively free of malaria. 

An interesting observation has been made in the 
Southwest Pacific regarding the incidence of ma- 


laria in colored troops. The negro of our southern 
states is relatively immune to vivax malaria in his 
native habitat, yet in the Southwest Pacific he is 
just as susceptible as the white man. Are we 
dealing with strains of malaria which vary in their 
degree of virulence and require different climatic 
conditions? Considerable data have already been 
gathered to support this view. 

Many of the members of our armed forces are 
returning home from highly malarious areas, either 
on furlough or are being discharged for medical 
reasons. Some of these persons after discontinu- 
ing- their routine suppressive atabrine therapy, sub- 
secpiently develop symptoms of malaria. Many of 
these cases present symptoms of an atypical na- 
ture so that influenza, brucellosis, virus pneumonia, 
and many other conditions are suspected rather 
than malaria. A number of such cases have come 
to my attention which were later verified as malaria 
by the demonstrations of malarial parasites in thick 
and thin blood films. Unfortunately many of our 
textbooks used by physicians in the temperate 
zones present the classical symptoms and findings 
in malaria, ignoring for the most part or barely 
mentioning the atypical cases. So protean are the 
signs and symptoms of malaria that it is being 
classed along with syphilis and brucellosis as one 
of the great masqueraders. So variable are these 
manifestations that every tropical physician consid- 
ers malaria as of first import in every differential 
diagnosis. Similarly, every member of the armed 
forces and workers returning to the United States 
from malarious areas, who consults his physician 
because of illness, must be considered potentially a 
victim of malaria until proved otherwise. If we 
adopt such a slogan, malaria will be promptly rec- 
ognized and treated so that it will continue to be 
of little import in present non-endemic areas. If 
we fail to do this, many cases of malaria will be 
overlooked and outbreaks of malaria in epidemic 
proportion may be encountered. It is important 
that we recognize in this group the chronic, latent, 
and asymptomatic cases during the seasons when 
malaria carrying mosquitoes are active. It is also 
important that we recognize the early cases of fal- 
ciparum malaria on account of its atypical perni- 
cious character which has a high mortality rate if 
it is not promptly diagnosed and treated. 

Following the prodromal period during which 
vague muscular pains, malaise, loss of appetite, 
headache and lassitude are noted the classical find- 
ings in malaria are chills, fever, and sweat. The 
primary chill or chilly sensation may resemble that 
of any acute infection but usually becomes pro- 
gressively more severe with each succeeding chill, 
so that the patient eventually literally shakes. In 
typical infections due to P. vivax, the paroxysms 


134 


Journal of Iowa State Medical Society 


of chills, fever, and sweat occur at periodic inter- 
vals of 48 hours, P. malariae 72 hours, and P. 
falciparum every 24 to 36 hours. Following the 
chill in the former two, the fever begins to rise 
and may reach 104 to 106 degrees. With the on- 
set of sweating the fever begins to drop, the pa- 
tient becomes relaxed and falls off to sleep. A 
period of well-being follows for 24 to 48 hours 
depending on the type of malaria. Following this, 
the patient again begins to experience the pro- 
dromal manifestations and then the chill, fever, 
and sweating. When it occurs this periodicity is 
typical of malaria, but in early cases and particu- 
larly in falciparum malaria it may he so irregular 
that malaria may not be suspected. Associated with 
the foregoing symptoms may be gastric discom- 
fort, urinary frequency, nausea, and vomiting. 

In falciparum malaria the frank chill is re- 
placed by a prolonged and intensified hot stage, a 
lack of profuse sweating and the presence of a 
continuous or remittent fever for several days in- 
stead of the classical intermittent fever curve. This 
irregularity in paroxysms is explained by a series 
of paroxysms coming on before the preceding one 
has terminated. Such an irregularity is frequently 
referred to as the “dumb chills” which are asso- 
ciated with severe apathy or prostration. These 
paroxysms come on following the rupture of the 
red blood cells containing the mature segmented 
parasites. It is in this type of malaria that enor- 
mous numbers of young malarial parasites may 
be found in tbe peripheral blood for a few hours 
after the paroxysm and then suddenly disappear 
until after the next paroxysm. Thus it is impor- 
tant that blood smears be taken daily or twice a 
day on each of three successive days. This dra- 
matic disappearance of parasitized red blood cells 
from the peripheral circulation is due to the ad- 
hesiveness of the red blood cells which form mi- 
nute clumps, plugs, or thrombi. These clumps may 
plug capillaries in any organ of the body or con- 
centrate in one organ, leading to bizarre symptoms 
referable to that organ. On such a basis several 
forms of malignant tertian malaria are described : 

1. The cerebral form may manifest iteself in a 

number of ways: (a) the hyperpyrexial form 

which simulates heat stroke : (b) the comatose or 
delirious form ; (c) the epileptiform or cerebellar 
form. 

2. The bilious remittent form, associated with 
gastric and biliary manifestations. 

3. The algid form, accompanied by severe dys- 
entery and frequently referred to as malarial 
dysentery. Fever is usually lacking. 

4. The cardiac form, resulting from dilatation 
of the right heart. 


April, 1945 

5. The pnemiKmic form, with symptoms of 
bronchopneumonia. 

As previously indicated, malaria relapses due to 
J’. vivax are frequent. It is felt that these re- 
lapses are due to failure on the part of the body 
defenses to resist the multiplication of the para- 
sites as is the case in latent malaria. In latent 
malaria there may be no obvious clinical manifes- 
tations and the parasites are rarely found in the 
l)lood even by the highly efficient thick film tech- 
nic. Such infections may accidentally come to 
light following blood transfusions, injury, cold 
exposure, lowered body resistance, and during 
other infectious processes. It is apparent that in 
non-endemic areas like Iowa we must become 
malaria conscious or suffer the consequences. 

We must also take cognizance of the fact that 
during malarial infections, the serologic tests for 
syphilis may become positive and revert to nega- 
tive following antimalarial therapy. Kolmer, the 
author of the Kolmer complement-fixation test in 
1929 stated that malaria in his experience had no 
effect upon the Wassermann reaction. Later, Gum- 
ming and his associate in the United States Public 
Health Service sent Kolmer a number of blood 
specimens from nonsyphilitic persons who were 
suffering from malaria, 19.4 per cent were re- 
ported as Wassermann positive. Nonspecific re- 
actions have been reported with the Kahn test by 
various workers ranging from 4.9 per cent to 80 
per cent. In a small series of nonsyphilitic sero- 
negative individuals inoculated with malaria by 
Rein and Elsberg,^ 44.4 per cent developed false 
positive serologic reactions between the seventh 
and fourteenth day following the first malarial 
paroxysm. 

Burney, Mays and IskranF report that eleven 
nonsyphilitic patients with dementia praecox de- 
veloped positive serologic tests for syphilis by one 
or more methods (Kahn, Kline and Kolmer) fol- 
lowing malaria inoculation. It is apparent from 
these reports that the nonspecific reactions are 
higher in vivax than in falciparum malaria and 
that the percentage of positives is higher fifteen 
to twenty-one days after the last previous parox- 
ysm. Such nonspecific reactions are noted in other 
so-called tropical diseases, such as yaws, leprosy, 
relapsing fever, trypanosomiasis, pinta, and many 
other febrile diseases. We must keep in mind that 
a positive serologic test does not always indicate 
the presence of syphilis. 

A definite diagnosis of malaria must be based 
on microscopic demonstration of the parasites in 
the blood films. Many an erroneous diagnosis has 
been made based solely on a temporary response 
to antimalarial drugs. It must be remembered that 
a single smear, and in some instances several 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


135 


smears, is inadequate to rule out malaria. This is 
particularly true in early, .chronic, and latent ma- 
laria when the parasitic density in the blood is low. 
In falciparum malaria, segmenting forms (pre- 
sporulating) are rarely found in the peripheral 
blood except in overwhelming infections and near 
death. The reason for this is that the red blood 
cells containing young parasites become sticky, re- 
sulting in their adhering to the capillary walls. As 
previously recommended where falciparum malaria 
is likely, blood smears should be taken twice a day 
on three successive days. It has been conclusively 
shown that it is necessary to have ten parasitized 
cells per cubic millimeter of blood before the para- 
sites can be, detected uniformly in blood smears. 
The ingestion of antimalarial drugs by persons 
with early, chronic, or latent malaria may interfere 
with the detection of parasites for several days. 

Blood films, both thick and thin, should be taken 
with the greatest of care. Miss i\imee Wilcox of 
the United States Public Health Service, who has 
popularized the thick blood film technic, in the 
preface of her manual® indicates the importance of 
the proper collection of blood specimens, “Well 
made films are the basic step toward reliable diag- 
nosis, and the best efiorts by a qualified technician 
may be frustrated by the poor condition of the 
material with which he has to work.” This man- 
ual, which is obtainable from the Superintendent 
of Documents, Washington, D. C., at a cost of 
forty-five cents, should be in the hands of every 
laboratorian interested in malaria diagnosis. The 
thick film properly prepared is a boon to the lab- 
oratorian. On numerous occasions, I have failed 
to find malarial parasites in thin films in from 
thirty to sixty minutes’ examination, whereas nu- 
merous parasites could be found in thick films 
within three to five minutes’ time. It has been 
stated by various workers that the thick film is 
twenty-five to fifty times more efficient than the 
thin film. The only disadvantages of the thick 
film, if such can be considered disadvantages, are 
that special staining technic (Giesma) is required 
and the microscopist must be familiar with the 
identification of the parasites in such preparations. 
In the staining of thick films the red blood cells 
are dehemoglobinized so that one sees in such 
preparations the malarial parasites and white blood 
cells primarily. After one becomes familiar with 
malaria parasite identification in thick films, the 
thin film is rarely ever examined. 

PROCEDURE FOR PREPARING AND MAILING BLOOD 
FILMS FOR MALARIA EXAMINATION 

When to Make Films — Blood should be taken 
a few hours before the chill, not during or just 
after the chill (Exception : when infections due to 
P. falciparum are suspected, make films on each 



Slide lying flat and protected from flies. 




136 


luruNAL OF Iowa State Medical Society 


April. 1945 


of three successive days, for reasons stated above 
the parasites may not be found on the first exami- 
nation). 

Hoiv to Make Films — A thin blood film slide as 
for differential blood count and a thick film slide 
taken prior to the chill and before quinine medi- 
cation are desirable. 



Thick and thin films. 


.tlx? m-uth xu-.\r\Ux\. {hkrvi-'-i k , u-j 

;hc enns'-.-in. hi 

: ■> ''t-iy M.ti, Tlic 

:t\« -Ijn* ccrtindlim) rw>MiTU>r nj 

It urr I r-x lah'ikjl is i<f 

:^4hy .tuh The hhrfU 

News print visible through wet thick film. Wet thick film does 
not photograph as densely as dried films of similar thickness. 

Thick films are especially advantageous in early 
mild, chronic, or latent infections, or, where ther- 
apy has been instituted. Malarial parasites may 
be demonstrated in a thick film when thin films 
are negative, since a larger amount of blood can 
be examined in a concentrated area. Thick films 
require a special staining procedure and must be 
examined by experienced workers. 

1. METICULOUSLY CLEAN, dry slides, 
free from grease, dust, acid, or alkali are essential. 

2. Cleanse finger tip with alcohol or ether and 
allow to dry. 

3. Puncture finger deeply so that blood will well 
up in a large drop with slight pressure. 

4. Touch slide to blood, with a rotary motion 
and without touching the finger, spread blood over 
an area the size of a dime. Make two such films 
on the same slide, one being thinner than the other. 

5. Allow films to air dry away from dust or 
flies. To dry slide, place face up in a covered clean 
slide box, drawer, or Petri plate. 

Caution : Smears should be thick enough so that 
ordinary newsprint can just be read when viewed 
through the wet blood film. Smears when too 
thick crack and peel ofif and when too thin lose the 
effect of concentration. Films will not adhere to 
greasy slides. Chemicals interfere with the stain- 
ing reaction. Debris may appear as artifacts sim- 


ulating malarial parasites. Experienced workers 
may make a thick and a thin film on the same slide. 
Care must be taken to see that these are widely 
separated. 

How to Ship — After slides are thoroughly dry, 
place in mailer face up. Fill out data card and 
mail at once. Slides more than several days old 
stain poorly and the red blood cells become resist- 
ent to dehemoglobinization. 

summary and conclusions 

1. Malaria transmitting moscjuitoes are widely 
distributed in Iowa. 

2. Every member of the armed forces or labor- 
ers returning from malarious areas who suffer 
from illness must be considered potentially ma- 
larious until proved otherwise. 

3. The diagnosis of malaria is based on the 
microscopic findings of malarial parasites in the 
blood of the patient. 

4. Thick films are 25 to 50 per cent more effi- 
cient than the thin films in the detection of malarial 
parasites. More information can be obtained in 
three to five minutes’ examination of a thick film 
than can be gained in thirty to sixty minutes in 
thin films. 

5. False positive serologic tests for syphilis are 
obtained with the blood of nonsyphilitic patients 
following the acute paroxysms and during chronic 
or latent malaria. 

BIBLIOGRAPHY 

1. Rowe, J. A. : Notes on distribution and breeding habitats of 
Iowa Anopheles. J. Iowa M. Soc., xxxi:279-280 (July) 1941. 

2. Petersen, W. J. : Doctors, Drugs and Dentists. Palimpsest 
xix:401-412 (October) 1938. 

3. Strong, R. P. : Stitt’s Diagnosis, Prevention, and Treatment 
of Tropical Diseases. Sixth edition, Blakiston Company, Philadel- 
phia, 1942. 

4. Rein, C. R., and Elsberg, E. S. : Studies on incidence and 
nature of false positive serologic reactions for syphilis. Am. J. 
Clin. Path., xiv:461-469 (September) 1944. 

5. Burney, L. E., Mays, J. R. S., and Iskrant, A. P. : Results 
of serologic tests for syphilis in non-syphilitic persons inoculated 
with malaria. Am. J. Pub. Health, xxxii :39-47 (January) 1942. 

6. United States Public Health Service: Manual for the Micro- 
scopical Diagnosis of Malaria in Man, by Aimee Wilcox. National 
Institute of Health Bulletin No. 180, 1943. 


A CLINICAL PERSPECTIVE ON THE 

Rh factor 

Elmer L. DeGowin, M.D. 

The four classic blood groups to which all hu- 
man beings may be assigned were first clearly 
defined independently by Jansky and Moss. Land- 
steiner showed that these groups occur because of 
the presence of either, both, or neither of two 
agglutinogens, A and B, in the cells and the agglu- 
tinins, anti-A and anti-B, in the plasma. The 
combinations result in the four blood groups, 
A, B, AB, and O. The agglutinins are naturally 
occurring antibodies which appear in the blood 
plasma soon after birth and increase in potency 

From the Department of Internal Medicine. 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


137 


during the first twenty years of life. So far as 
is known, their presence is not a response to anti- 
gens. Proper recognition of the importance of the 
properties of the groups in the ABO system has 
made possible the modern practice of blood trans- 
fusion. 

It was soon realized that human red cells con- 
tain many other agglutinogens which can be iden- 
tified by special tests. By injecting human red cells 
from various sources into rabbits, Landsteiner and 
Levine were able to produce antisera which divide 
the members of the human race into three blood 
groups which are inherited independently of the 
ABO system. These groups were designated M, 
N, and MN. They have not proved important in 
clinical medicine because there are no naturally 
occurring agglutinins which act upon them and the 
M and N agglutinogens apparently are poor anti- 
gens when injected into persons of other groups 
in this system. Therefore the practical importance 
has been restricted to the further differentiation of 
the identity of human bloods in forensic medicine. 

Full application of the knowledge of these two 
systems of blood groups has not proved adequate, 
however, in explaining rare transfusion reactions 
due to incompatibility. In 1939 Levine and Stet- 
son’^ studied the case of a woman who hemolyzed 
the transfused blood of her husband after she had 
been delivered of a macerated fetus. It was found 
that her serum contained an agglutinin which 
clumped the cells of about 80 per cent of persons 
belonging to group O. The agglutinable factor 
could not be identified with any known agglutino- 
gen. The hypothesis was advanced that she had 
developed an antibody against the tissues of the 
fetus. The next year, Landsteiner and Wiener^ 
developed an antiserum by injecting the red cells 
from the rhesus monkey into rabbits. The rabbit 
serum was found to agglutinate the red cells from 
approximately 85 per cent of human beings, re- 
gardless of the presence of agglutinogens A, B. 
M, N, or P. They called this agglutinable sub- 
stance the Rh factor and persons whose cells con- 
tained it were designated as Rh positive; those 
without it as Rh negative. Wiener and Peters® 
reported cases of hemolytic transfusion reactions 
in Rh negative recipients who had developed anti- 
Rh agglutinins by receiving multiple transfusions 
of Rh positive blood. Levine and his coworkers'* 
soon presented evidence to prove that the rare 
obstetric disease of erythroblastosis fetalis was the 
result of development of isoimmunity to the Rh 
factor. 

Since the original contributions in this field, the 
subject has received intensive study. It has been 
shown that the possession of the Rh factor is in- 
herited as a mendelian dominant character and is 


present in approximately 85 per cent of the white 
persons in certain parts of the United States-. It 
is also apparent that the proportion of Rh positive 
to Rh negative persons varies in different races. 
Less than 1 per cent of Japanese studied, for ex- 
ample, are Rh negative. 

Persons whose blood is Rh negative are vul- 
nerable in one or two respects. If they are 
males, they may, after receiving a series of trans- 
fusions of Rh positive blood, develop aggluti- 
nins against the Rh factor which results in hemol- 
ysis of further transfused Rh positive blood. 
If they are females, in addition to the possi- 
bility of becoming immunized by repeated trans- 
fusions, isoimmunization by pregnancy may occur. 
The mathematical probability is great that an Rh 
negative female will marry an Rh positive husband 
and have children whose blood is also Rh positive. 
A woman so situated may bear several children 
whose blood contains the Rh factor. With re- 
peated similar experiences, her blood plasma may 
develop anti-Rh agglutinins. These antibodies 
diffuse through the placenta and act against the 
Rh positive blood cells of the fetus, producing a 
hemolytic type of anemia in the latter. This dis- 
ease of the fetus has long been known as erythro- 
blastosis fetalis. This may result in fetal death 
and abortion, or in the birth of a deeply jaundiced, 
anemic infant. If the child is viable, its condition 
usually demands transfusions of blood for the 
treatment of the anemia. Although its blood is 
Rh positive, the tissues are saturated with anti-Rh 
agglutinins from the mother and transfused Rh 
positive blood cells are quickly destroyed and are 
therefore ineffective. Transfusions of Rh nega- 
tive blood, on the other hand, are well tolerated. 
Should the mother recpiire blood transfusions dur- 
ing the course of the labor and puerperium, special 
consideration must be given. Her blood contains 
antibodies against the Rh factor so that transfu- 
sion of Rh positive blood, as from the husband, 
results in a hemolytic reaction. 

In the extensive literature which has accumu- 
lated on the phenomena of isoimmunity, it has 
been difficult to obtain a clinical perspective on the 
importance of the Rh factor. Most of the papers 
have dealt with the study of a few selected cases, 
leaving the clinician uncertain as to the frequency 
with which isoimmunity occurs. The incidence of 
erythroblastosis fetalis has been known for many 
years and this condition has been recognized as a 
relatively rare disease. Although the combination 
of Rh negative mother and Rh positive child oc- 
curs in approximately one in ten pregnancies, only 
one in 400 pregnancies results in erythroblastosis 
fetalis. It was also known in a general way that 
many Rh negative persons could receive multiple 


138 


Journal of Iowa State Medical Society April, 1945 


transfusions without becoming sensitized to the 
Rli factor. 

Some perspective on the incidence of transfusion 
reactions due to isoimmunity to the Rh factor can 
be obtained from a study made in the Blood Trans- 
fusion Service of the University Hospitals. Dur- 
ing a period of 18 months 5,386 consecutive blood 
transfusions were given to 2,1 16 recipients. Trans- 
fusions were administered without regard for Rh 
type of the donor or recipient and without refer- 
ence to the obstetric histories of the female recip- 
ients. When transfusion reactions occurred, the 
bloods concerned were typed for the Rh factor 
and tested for the presence of anti-Rh agglutinins. 

The total number of reactions of all types 
was 186, an incidence of 3.4 per cent. Of these, 
only six were found to be due to sensitivity to the 
Rh factor. Four were from isoimmunity, appar- 
ently produced by four or more blood transfusions, 
and two were caused by pregnancies. In a large 
general transfusion service, then, only 0.1 per cent 
of the blood transfusions involving donors and 
recipients, unselected for the Rh factor, were at- 
tended by reactions attributable to isoimmunity to 
the Rh agglutinogen. Only one of the six reac- 
tions resulted in a fatality. The details of this 
study are reported elsewhere.® 

In this series, none of the recipients developed 
isoimmunity to the Rh factor with less than four 
blood transfusions. From the data available, it 
was estimated that of approximately 60 recipients 
who were Rh negative only four (6.6 per cent) 
were immunized by four or more transfusions. 

It is then evident that isoimmunity, either from 
pregnancy or from multiple blood transfusions, is 
a rare occurrence compared to the frequency which 
is theoretically possible. At present there are 
many practical difficulties attendant upon routine 
typing of bloods for the Rh factor and the testing 
of sera for the presence of anti-Rh agglutinins. 
Typing serum is difficult to obtain in sufficient 
quantities. The only satisfactory source now 
known is from the blood of persons who have been 
immunized by multiple blood transfusions or from 
the blood of women who have borne erythroblas- 
totic children. A disappointingly small number of 
these women possess sufficiently potent antibodies 
to serve as typing serum. The technic of testing 
bloods for Rh incompatibility prior to transfusion 
is far from satisfactory. The appropriate cells 
and serum must be incubated at 37 degrees centi- 
grade for at least thirty minutes. Clumps result- 
ing from the presence of agglutinins are frequent- 
ly very small and difficult to interpret. Differen- 
tiation from rouleau formation is occasionally un- 
certain. Some reactions from incompatible trans- 


fusions cannot be prevented by any known method 
of cross matching. 

BIBLIOGRAPHY 

1. Levine, P., and Stetson, R. E. ; Unusual case of intra-group 
agglutination. J.A.M.A., cxiii :126-127 (July 8) 1939. 

2. Landsteiner, K., and Wiener, A. S. : Agglutinable factor in 
human blood recognized by immune sera for rhesus blood. Proc. 
Soc. Exper. Biol. & Med., xliii :223 (January) 1940. 

3. Wiener, A. S., and Peters. H. R. : Hemolytic reactions fol- 
lowing transfusions of blood of homologous group, with 3 cases in 
which the same agglutinogen was responsible. Ann. Int. Med., 
xiii:2306-2322 (June) 1940. 

4. Levine, P., Katzin, E. M., and Burnham, L. : Isoimmunization 
in pregnancy; its possible bearing on etiology of erythroblastosis 
foetalis. J.A.M.A., cxvi :826-827 (March 1) 1941. 

6. DeGowin, E. L. : Isoimmunity to the Rh factor as a cause 
of blood transfusions reactions. J. Lab. & Clin. Med., xxx:99-106, 
1945. 


SOME OBSERVATIONS ON THE 
DETERMINATION OF THIOCYANATE 
IN BLOOD SERUM AND PLASMA 
R. B. Gibson, Ph.D. 

In the course of routine thiocyanate determina- 
tions for the control of hypertension therapy, it 
was noted that inconsistent and unexpectedly low 
results were obtained when hlood plasma was em- 
ployed instead of serum. Barker’s procedure’" ^ 
calls for “serum or plasma,’’ and Barker’s proce- 
dure is the method recommended in recently pub- 
lished clinical laboratory manuals.* Clinical re- 
ports of “hlood thiocyanate’’ have sometimes failed 
to specify whether serum, plasma or whole blood 
was used. Crandall and Anderson,® using essen- 
tially Barker’s method, state that “This procedure 
cannot be used with whole hlood, although a small 
amount of hemolysis does not impair the accuracy 
of the determination in serum.” 

Fortunately, and perhaps fortuitously, studies on 
so-called available water content in the body, have 
also been carried out with the technic of Lavietes, 
Bourdillon and Klinghoffer."’ These investigators 
collected blood under oil, used serum for the thio- 
cyanate determination, and added an equal volume 
of the ferric nitrate ( Schreiber’s®) reagent to the 
trichloracetic acid filtrate instead of 1 volume of 
reagent to 5 of filtrate as in Barker’s procedure. 
These writers state also that following its admin- 
istration the concentration of thiocyanate present 
in the blood cells is about the same as in the serum. 
Molenaar and Roller® say that the membrane of 
uninjured (heparinized) red cells are impermeable 
to thiocyanate, but permeability of the cells is 
generally assumed in available water measure- 
ments. 

The present study was undertaken to determine 


From the Pathological Chemistry Laboratory. 

♦To 6 cc. of 10 per cent trichloracetic acid in a test tube, add 
5 cc. of serum or plasma. Stopper and shake well. Allow to stand 
for 10 to 16 minutes and filter. Transfer 5 cc. of the clear filtrate 
to a test tube. Add 1 cc. of the ferric nitrate reagent and mix. 
Prepare 3 standard tubes containing 0.5, 0.35 and 0.20 mg. of 
CNS in 6 cc. respectively, add to each 5 cc. of trichloracetic acid 
and 2 cc. of ferric nitrate reagent and mix. Compare the un- 
known with the nearest standard in a colorimeter ; or determine 
photometrically after preparing a calibration curve (Am. J. Clin. 
Path. Tech., Suppl. 2. 153, 1938). 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


139 


the effect on the analysis of the anticoagulant em- 
ployed, the merit of the collection under oil, and 
the extent of thiocyanate penetration into the 
blood cells. Before considering these points, how- 
ever, the optimum proportion of ferric nitrate re- 
agent and filtrate for maximum color development 
(1 cc. to 5 cc. of reagent for 5 cc. of filtrate) was 
established and the disputed question of fading 
made clear. 

Maximum Color Production — Twenty cubic 
centimeters of a standard containing 10 mg. 
KCNS per 100 cc. solution, were diluted to 60 cc. 
and 20 cc. of 20 per cent trichloracetic acid added. 
To 5 cc. of this mixture was added 1 cc. of 
Schreiber’s reagent for a standard, and 2, 3, 4 and 
5 cc. respectively of the reagent to similar 5 cc. 
portions. Colorimetric thiocyanate recoveries, cor- 
rected for dilution with the reagent and taking the 
1 cc. reagent addition as 100, were respectively 110, 
121, 123, and 125. When 5 cc. of the same thio- 
cyanate solution was oven dried, made up to 3 cc., 
and 3 cc. of Schreiber’s reagent added, the ratio 
was 100:124. Equal volume of filtrate and ferric 
nitrate reagent should be employed for maximum 
color development. 

Fading — According to Lavietes, Bourdillon and 
Klinghoffer, the color produced when the ferric 
nitrate reagent is added to trichloracetic acid serum 
filtrate fades after ten minutes. Chesley'^ has 
stated that the color is stable two hours. Molenaar 
and Roller failed to confirm the results of Lavietes. 
Bourdillon and Klinghoffer with reference to fad- 
ing. We have found that the color is promptly 
developed and fades rapidly unless the tubes are 
kept in subdued light or in the dark. 

Readings with the Fisher electrophotometer 
were made on 2 standard KCLIS solutions and 4 
trichloracetic acid serum filtrates 5, 10, 30, and 
60 minutes and 18 hours after the development of 
color with the reagent. The color tubes were kept 
in subdued light and overnight in darkness. The 
logarithmic readings proportional to the color in- 
tensity for one filtrate tube were 46.6, 46.7, 45.7, 
44.5, and 41.5 respectively. The other standard 
and serum filtrates were consistent. Tubes kept 
in bright light (not sunlight) faded so rapidly 
that such exposure for between two and three 
hours lead to almost complete loss of color. 
Twenty milligrams per cent standard tubes were 
decolorized completely in eighteen minutes in sun- 
light transmitted through window glass. 

Effect of Anticoagulants on the Thiocyanate 
Reaction — The effects of sodium oxalate, sodium 
fluoride, and sodium citrate added to serum fil- 
trates containing thiocyanate, when 1 cc. and 5 cc. 
of the Schreiber reagent were added to 5 cc. of 
filtrate and read in a colorimeter against standards 


made with similar proportions of trichloracetic 
acid and reagent, were studied. A measured 
amount of each solution of anticoagulant was oven 
dried in a tube and then dissolved in 5 cc. of serum 
filtrate (serum 1, water 3, and 20 per cent tri- 
chloracetic solution 1 part by volume). With 1 
cc. of the reagent, both oxalate and fluoride pro- 
gressively inhibited the color development in in- 
creasing concentrations over the minimum ordi- 
narily used to prevent coagulation (usually 3 mg. 
per 1 cc. of blood). Equal volumes of filtrate and 
reagent, however, gave a maximum color both for 
oxalate and fluoride containing filtrates. Citrate 
did not inhibit the reaction with 1 cc. of reagent 
but gave some color in the blank. 

Permeability of Red Cells to the Thiocyanate 
Ion — Blood samples drawn from two patients were 
defibrinated or heparinized (0.1 cc. heparin to 
20-25 cc. of blood). Measured amounts of blood 
were introduced into graduated centrifuge tubes 
or flasks containing the desired amounts of KCNS 
(solution) oven dried in the tubes. The tubes were 
incubated for two hours at 37° centigrade and 
then centrifuged. The two hours represent the 
usual lapse of time between injection of thiocya- 
nate and withdrawal of the blood sample in avail- 
able body water tests. The serum or heparinized 
plasma was drawn off, and the tubes again centri- 
fuged until constant values for cell volume Vv^ere 
obtained. 

Electrophotometer (Fisher) determinations of 
serum thiocyanate were made using the micro at- 
tachment and a- number 436 filter. One cc. of 
serum was diluted to 9 cc. and precipitated with 
1 cc. of 20 per cent trichloracetic acid. Five cubic 
centimeters of Schreiber’s reagent (ferric nitrate 
25 grams, concentrated nitric acid 12.5 cc., water to 
500 cc.) was added to 5 cc. of the filtrate. The thio- 
cyanate distribution between serum and cells was 
calculated. There was little difference in the thio- 
cyanate concentration of heparin plasma and of 
defibrinated blood serum in paired tests (3 pa- 
tients). The percentage recovery in serum of 
KCNS added to the blood varied inversely with 
the blood thiocyanate level. For example, at a 10 
milligrams per cent level, 81 per cent of the added 
thiocyanate was in the serum from heparin-blood 
and at a blood level of 25 milligrams per cent the 
serum contained 76.4 per cent. 

Thiocyanate Shift — A thiocyanate shift from 
cells to serum was found. Colorimetric thiocya- 
nate determinations on two specimens of serum 
from defibrinated blood samples containing 20 
milligrams per cent of KCNS, showed a recovery 
in the serum at 0.5 hour at 37° centigrade of 
69.5 and 65 per cent, at 1.5 hours of 73.5 and 70 
per cent, at 3.5 hours of 81 and 79 per cent and 


140 


Journal of Iowa State Medical Society 


at 6.5 hours of 84.5 and 83.5 per cent. Blood 
from two other subjects allowed to clot under oil 
showed no such shift in the same period. By pho- 
toelectric measurement the shift was found to 
occur whether the blood was kept at 37° centigrade 
or at room temperature, but it did not take place if 
the blood was overlaid with oil. Blood drawn 
from a hypertensive patient at intervals of four 
days after thiocyanate treatment (0.33 gram pef 
day) was collected under oil and defibrinated. A 
portion was centrifuged under oil immediately and 
the serum drawn ofif ; two other portions were kept 
for six hours, one under oil, the other exposed to 
air. KCNS determinations on the fresh, oil-cov- 
ered, and exposed serum samples were for Day 5 
of treatment, 6.4, 6.0 and 6.6 mg. per cent, Day 
9 of treatment. 10.5, 9.9 and 11.2 mg. per cent, 
and for Day 13, 16.2, 15.9 and 17.2 mg. per cent, 
respectively. 

Summtary — The color produced by Schreiber’s 
ferric nitrate reagent with thiocyanate is maximum 
when equal volumes of reagent and serum filtrate 
are employed but fades on exposure to light. 
Oxalates and fluorides inhibit the color develop- 
ment in Barker’s procedure, but no inhibition oc- 
curs if equal volumes of filtrate and reagent are 
used. Heparinized and defibrinated blood cells 
are both permeable to the thiocyanate ion, the 
more concentrated the thiocyanate the still great- 
er concentration in the cells. An in vitro thio- 
cyanate shift from cells to serum occurs on ex- 
posure to air. Serum separated from blood col- 
lected under oil should more exactly represent the 
actual intravenous plasma content of thiocyanate. 
The results confirm and explain the validity of 
the technic of Lavietes, Bourdillon and Kling- 
hoffer in available water studies. 

bibliography 

1. Barker, M. H. : Blood cyanates in treatment of hypertension. 
J.A.M.A., cvi:762-767 (March 7) 1936. 

2. Barker, M. H., Lindberg, H. A., and Wald, M. H. : Further 
experiences with thiocyanates ; clinical and experimental observa- 
tions. J.A.M.A., cxvii :1591-1694 (November 8)1941. 

3. Crandall, L. A., Jr., and Anderson, M. X.: Estimation of 
state of hydration of body by amount of water available for solu- 
tion of sodium thiocyanate. Am. J. Digest, Dis. & Nutrition, 
i:126-131 (April) 1934. 

4. Lavietes, P. H., Bourdillon, J., and Klinghoffer, K. A.: 
Volume of extracellular fluids of body. J. Clin. Investigation, xv: 
261-268 (May) 1936. 

5. Schreiber, H. : Ueber den Rhodangehalt im menschlichen 

Blutserum. Biochem. Ztschr., Berl., clxiii :241-251, 1925. 

6. Molenaar, H.. and Roller, D. : Die Bestimmung des extracel- 
lularen Wassers beim Gesunden und Kranken. Ztschr. f. klin. 
Med., cxxxvi:l-32, 1939. 

7. Chesley, L. C. : Determination of thiocyanate in biological 
fluids. J. Biol. Chem., cxl:135-141 (July) 1941, 


Skeleton meeting of the House of Dele- 
gates will be held in Des Moines April 
18 and 19 at Hotel Fort Des Moines. 


April, 1945 

BACTERICIDAL LAMP CONJUNCTIVITIS 
Roland Rooks, Ph.D. 

I'he Council on Physical Thei'apy of the Ameri- 
can Medical Association has accepted certain ultra- 
violet lamps for disinfecting purposes. This ac- 
ceptance is “limited to ultraviolet disinfecting 
lamps designed for installation in hospital nur- 
series, hospital wards and operating rooms.’’^ 

In lamp installations the danger of direct ex- 
posure, especially to the eyes, has been recognized 
but the rather significant percentage of indirect 
rays which are reflected from the lamp or even 
from a wall or floor surface has not been gener- 
ally appreciated. For this reason the following 
observations are of interest. 

I. Rays from the lamp’s reflector — A member 
of the staff tested the output of a lamp emitting 
rays of 2,537 Angstrom’s units, the meter used 
being a tantalum photocell which clicks once for 
each exposure of 200 microwatt seconds per square 
centimeter. During this measurement his eyes 
were carefully protected against the direct rays of 
the lamp. He had previously suffered three at- 
tacks of conjunctivitis due to careless exposure to 
direct rays. In order to ascertain whether re- 
flected rays would cause these symptoms, he delib- 
erately exposed his eyes to such rays as might be 
coming from the lamp’s reflector. The measured 
dosage of these reflected rays to which he sub- 
jected himself was fifteen clicks, as defined above. 
The distance of his eyes from the reflector was 
eighteen inches and the duration of exposure was 
seven minutes. That night, some twelve hours 
later, he was awakened from sleep by the symp- 
toms of a moderately severe conjunctivitis charac- 
terized by pain, lacrimation, photophobia, and the 
sensation of “sand in the eyes.” This subsided 
within a few hours but was distressing during the 
acute stage. He was unwilling to repeat the ex- 
periment to ascertain whether a lower dosage 
would cause symptoms. 

Taking an exposure of fifteen clicks as a basis, 
additional readings were made to find whether this 
dosage could result from lamps improperly in- 
stalled. It was found that at a distance of five 
feet from the lamp, the rays from the reflector 
attained a dosage of fifteen clicks in three and one- 
half hours. This means that with the lamp in- 
stalled seven feet above the floor, a person lying 
on a nearby bed with eyes unprotected against the 
lamp’s reflector for several hours could receive a 
dosage of this amount. This may be of impor- 
tance in nurseries, since babies may watch the re- 
flector unless completely shielded from it. 

II. Rays reflected from zvalls — The lamp was 


From the Department of Hygiene and Preventive Medicine. 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


141 


turned to face a wall, one foot distant, and the 
meter was set up slightly above the lamp and two 
feet distant from the wall. In this location the 
meter recorded fifteen clicks in fifteen minutes 
when the wall was of a soft surface. It recorded 
fifteen clicks in. seven and one-half minutes when 
the lamp faced a hard-surfaced hospital wall. 

This latter measurement was observed by a hos- 
pital electrician, who was wearing glasses and who 
stood behind the meter. He was warned as to 
the possible effect of the rays reflected from the 
wall. However, during conversation he turned his 
face sidewise to the wall in which position the 
glasses no longer protected one eye. He received 
a sufficient dosage of reflected rays to cause a 
conjunctival irritation in the outer portion of the 
left eye. The exact dosage which he received is 
not known, but it was received during the inter- 
val of thirty minutes which the series of readings 
in that room required. Thus, walls, especially 
hard-surfaced walls, do reflect appreciable amounts 
of these rays. 

HI. Rays reflected from concrete floors — -The 
lamp was faced downward at a distance one foot 
above a smooth concrete floor. The meter was 
placed three and one-half feet above the floor, 
which is the approximate level of the eyes of an 
individual seated in a chair. The rays reflected 
from the floor to the meter in this instance traveled 
approximately five feet. The meter in this posi- 
tion recorded fifteen clicks in three and one-half 
hours. Thus, the rays definitely are reflected from 
concrete floors. 

In a recent publication it is suggested that “floor 
irradiation be combined with ceiling irradiation in 
barracks or hospital wards to determine the effect, 
if any, of ultraviolet irradiation in lowering mor- 
bidity rates or preventing cross infection.”^ A 
warning is included in this report to the effect 
“that certain types of flooring may prove to be 
capable of reflecting sufficient amounts of ultra- 
violet to cause harmful effects.” 

The observations recorded above indicate that 
the rays reflected from the lamp’s reflector or from 
walls or floors'may be sufficient under certain con- 
ditions, over a period of minutes or hours, to cause 
conjunctivitis. 

The intensity of radiation is inversely propor- 
tional to the square of the distance between the 
point of source and the irradiated surface so that 
control of the distance over which the reflected 
light must travel affords a safeguard. By aiming 
all direct and reflected rays toward a ceiling of 
soft finish, it should be possible to control the dis- 
tance and thus to avoid significant dosages of rays 
reflected therefrom. However, it would appear 


difficult safely to irradiate the floors in occupied 
rooms because of the reflected rays. 

BIBLIOGRAPHY 

1. Council on Physical Therapy: Ultraviolet lamps for disin- 
fecting purposes ; introductory statement. J.A.M.A., cxxiii :92-93 
(September 11) 1943. 

2. Hollaender, A., du Buy, H. G., Ingraham, H. S., and Wheeler, 

S. M. : Control of air-borne microorganisms by ultraviolet floor 

Irradiation, Science, xcix:130-131 (February 11) 1944. 


HOUSE OF DELEGATES MEETING 

Although it will be impossible to hold the usual 
annual scientific program in 1945 clue to the wartime 
restriction on conventions, it is planned to have a 
skeleton meeting of the House of Delegates in order 
to transact the necessary business of the Society. 
Plans are now being made to have each district 
represented by three delegates who, together with 
the Executive Council, will carry on, yet still keep 
the number of those present under the limit of fifty. 

It was hoped originally that it would be possible 
to provide proxies for the delegates not present, but 
legal opinion is that our constitution and by-laws 
prohibit this because they specifically provide for an 
alternate should the delegate be unable to attend. 
Consequently, it is hoped that the district will feel 
adequately represented by the three delegates 
chosen to come to the meeting. 

The officers of the State Society feel it is much 
better to have this skeleton meeting of delegates 
than to let the Executive Council assume the whole 
responsibility, which we are told would be permissible 
under the constitution and by-laws. Ours is a demo- 
cratic society and we wish to preserve it as such 
even under the restrictions of wartime. Ours is also 
a loyal and patriotic society, and we are confident 
its members would not welcome any attempt to vio- 
late the ruling limiting attendance at meetings to 
not over fifty persons from out of town. We all 
hope that next year it will be possible to resume 
the usual procedure of holding an annual scientific 
session and full meeting of the House of Delegates, 
but in the meantime our effort will be directed 
toward doing the best we can under the circum- 
stances and helping as much as possible to bring 
an early conclusion to the war. 


IOWA CONFERENCE ON CHILD DEVELOP- 
MENT AND PARENT EDUCATION 
The annual Iowa Conference on Child Development 
and Parent Education, usually held in Iowa City, 
will not meet this June because of ODT travel re- 
strictions. There will be a five-day Workshop in 
Home-School Cooperation, June 14, 15, 16, 18, and 
19, sponsored jointly by the Iowa Child Welfare 
Research Station, the National Congress of Parents 
and Teachers, and the Iowa Congress of Parents 
and Teachers. The workshop is designed both for 
students on campus and for others interested in this 
field, and carries one semester hour of credit. Dr. 
Ralph H. Ojemann will act as coordinator. Detailed 
information may be secured by writing the Iowa 
Child Welfare Research Station, Iowa City, Iowa. 


142 


joi'RXAL or Iowa State MEoicAr- Society 


April, 1945 



April 23 is a significant day on the 1945 cal- 
endar in marking the sixty-fifth anniversary of the 
inception of the Iowa State Department of Health. 

The first Biennial Report of the State Board of 
Health, published in 1882, contains the secretary’s 
report which begins as follows : 

“Pursuant to chapter 151, laws of the Eight- 
eenth General Assembly, the Governor (Hon. John 
H. Gear), on the twenty-third day of April, A. D., 
1880, commissioned the following persons to con- 
stitute the State Board of Health : 

William S. Robertson, M.D., Muscatine; Phillip 
W. Lewellen, M.D., Clarinda; Wilmot H. Dick- 
inson, M.D., Des Moines; Henry H. Clark, M.D., 
McGregor; Justin M. Hull, M.D., Lake Mills; 
Ephraim M. Reynolds, M.D., Centerville; George 
F. Roberts, M.D., Waterloo; James L. Loring, 
Civil Engineer, Dallas Center ; John F. Mcjunkin, 
attorney general, Washington.” 


Dr. W. S. Robertson was elected president and 
Mr. L. F. Andrews, secretary, at the first meeting 
held at the State Capitol on May 5, 1880. Dr. 
Robert Farquharson became medical secretary on 
May 5, 1881. He served for three years until 
his untimely death in 1884. 

IOWA’S HEALTH IN 1880 

The foregoing Biennial Report for the period 
1880-1881 contains the Introductory Address of 
President Robertson, presented May 5, 1880, and 
which reads in part as follows ; 

“It is a subject of gratulation that the last leg- 
islature has placed our State abreast of so many 
of her sister States on the good work of sanitary 
progress, by creating a State Board of Health, 
which may inaugurate such measures as will mate- 
rially limit the spread, and reduce the mortality 
of many of the diseases of the country ; and, if 
necessary, enforce such sanitary regulations as 



IOWA STATE BOARD OF HEALTH 
Commissioned by Governor John H. Gear, April 23, 1880 

Upper row, left to right: William S. Robertson, M.D. (R) ; Wilmot H. Dickinson, M.D. (H) ; Henry H. Clark, M.D. (R) ; 

Ephraim M. Reynolds, M.D. (R). 

Lower row: Phillip W. Lewellen, M.D. (R) ; George F. Roberts, M.D. (H) ; Justin M. Hull, M.D. (E). 


VoL. XXXV, No. 4 


143 


Journal of Iowa State Medical Society 


will largely stamp out these influences which be- 
come prolific causes of disease. 

“It is an old proverb that ‘forewarned is fore- 
armed’. It shall then become our duty to do much 
toward educating the people in the principles of 
hygiene and sanitary reform ; to show them some- 
thing of the nature and many of the causes of 
disease, and to impress them with the knowledge 
of the fact that in their manner of life, and in 
their every day surroundings, lie many of the 
means of inducing or preventing the encroach- 
ments of disease.” 

The address, covering well over two closely 
printed pages, ends as follows : 

“In conclusion. Gentlemen, let me express the 
hope that the operation of this Board in the sani- 
tary measures it may inaugurate and carry out, 
may so demonstrate the wisdom of its creation 
that it may prove a blessing to the whole State 
and that, with advancing years it may develop a 
strength and influence for good which shall make 
Iowa one of the most salubrious, as it is one of 
the most prosperous. States of our confederation.” 

The same biennial report contains accounts of 
severe epidemics of diphtheria, typhoid fever, and 
smallpox of sixty-five years ago. Of particular 
interest is the report by the late Ward Woodbridge, 
M.D., of diphtheria (54 cases, 15 deaths) in Wau- 
beek, Linn County, and vicinity ; also articles deal- 
ing with W ater Supply, Slaughter Houses, Gland- 
ers, Adulteration of Food, Diseases of Domestic 
Animals, Disposal of Excreta, and Smallpox Hos- 
pital, the last named with illustrations of floor plans 
and construction of an Isolation Hospital for 
smallpox patients. 

community health in 1945 

The leaders who guided the State Department 
of Health in its infancy, lived at the threshold of 
the New Era in Medicine. Although the causa- 
tive agents of diphtheria and tuberculosis were 
unknown in 1880, discovery of the typhoid bacil- 
lus was announced in that year, followed during 
the eighties and nineties by many similar, epoch- 
making discoveries in the realm of bacteriology 
and immunity. 

Today, in 1945, we reap the benefits of knowl- 
edge, cumulative through the closing decades of 
the nineteenth century and the years thus far in 
the twentieth century. In 1880, public water sup- 
plies were untreated and pasteurization unknown ; 
in 1945, community life could scarcely exist with- 
out modern Public Health Engineering. In that 
day there was but little of chemotherapy and anti- 
sepsis — now, the marvels of sulfatherapy, peni- 
cillin, aseptic surgery ; then a period of peace — 
today, the critical throes of a second World War ; 
then, the vivid memory of Florence Nightingale — 
now, the Public Health, the Visiting and the Red 


Cross nurse. At that time there was the small 
community and the village blacksmith — today, the 
age of the Machine, of Industrial Flygiene, of 
Maternal and Child Health, of Certification of 
Births and accurate recording of Deaths ; yester- 
day, diphtheria and the pest house — today, the 
spectre of communicable disease still raises its 
head, throttled however by increased emphasis 
upon immunization, x-ray therapy, measures for 
disease control, and adequate local health organ- 
ization. 

The health structure of 1945 was made possible 
by the solid foundation laid in 1880. The vision 
and foresight of founders and silent witnesses 
impel attending physicians and all public health 
workers to a rededication of efifort as together we 
face new horizons. 


IMMUNE SERUM CxLOBULIN AVAILABLE 
THROUGH AMERICAN RED CROSS 
A letter to the Commissioner from G. Foard Mc- 
Ginnes, M.D., National Medical Director, American 
Red Cross, dated March 5, 1945, reads in part as fol- 
lows: “The plan (for supplying immune serum 

globulin) has been modified in that the entire cost 
of processing and delivering the globulin to the 
state health departments wishing to use it will be 
borne by the American Red Cross. Funds have been 
appropriated for this purpose on the ground that 
globulin accumulated in excess of the needs of the 
armed forces should be given back to the American 
people, who have made it available through the 
American Red Cross Donor Service. 

“Accordingly, as long as the present stock lasts, 
the Amei’ican Red Cross will be glad to supply im- 
mune serum globulin at no cost, in quantities to 
meet the civilian needs within your jurisdiction. 
This will be done on condition that the product will 
be used for the prophylaxis, modification and treat- 
ment of measles, that it will be distributed with- 
out charge to physicians, hospitals, and clinics in 
accordance with applicable laws and regulations, 
and that it will be administered in accordance with 
established standards and without any charge to the 
patient for the product.” 

The State Department of Health has a supply of 
immune serum globulin (gamma globulin), secured 
from the American Red Cross and available for dis- 
tribution to physicians and hospitals in Iowa. 


PREVALENCE OF DISEASE 


Most Cases 


Disease 

Feh. ’45 

Jan. '45 

Feb. 

'44 Reported From 

Diphtheria 

8 

21 

19 

Clinton, Scott 

Scarlet Fever . . . . 

. 271 

389 

718 

Polk, Union, Dubuque 

Typhoid Fever . . . 

. *14 

0 

1 

Polk, Cerro Gordo 

Smallpox 

1 

0 

3 

Union 

Measles 

. 94 

127 

1516 

Woodbury, Guthrie, 

Whooping Cough . 

. 17 

32 

86 

Pottawattamie 
Webster, Dubuque 

Brucellc^is 

.**99 

8 

15 

For the State 

Chickenpox 

. 420 

364 

313 

Dubuque, Des Moines, 

German Measles . 

5 

0 

11 

Woodbury 

Boone, * Allamakee, 


. . 0 

0 

150 

Des Moines 

Malaria 

3 

4 

0 

Black Hawk, Polk, 

Meningococcus 
Meningitis . . 

8 

8 

23 

Wapello 
Iowa, Scott 

Mumps 

. 311 

380 

123 

Dubuque, Johnson, 

Pneumonia 

. 21 

43 

87 

Black Hawk 
Boone, Marion 

Poliomyelitis . . . . 

2 

0 

0 

Lyon, Webster 

Tuberculosis 

91 

53 

60 

For the State 

Gonorrhea 

. 217 

266 

143 

For the State 

Syphilis 

. 144 

143 

224 

For the State 


*12 of the 14 Cases are Delayed Reports 
**99 Delayed Reports 


144 


Journal of Iowa State Medical Society 


April, 1945 



ISSUED MONTHLY 


Leb Forrest Hill, Editor Des Moines 

Dennis H. Kelly, Associate Editor Des Moines 

PUBLICATION COMMITTEE 

Lee Forrest Hill, Editor Des Moines 

Dennis H. Kelly, Associate Editor Des Moines 

Robert L. Parker, Secretary Des Moines 

Oliver J. Fay, Trustee Des Moines 

John I. Marker, Trustee Davenport 

Walter A. Sternberg, Trustee Mount Pleasant 


SUBSCRIPTION $3.00 PER YEAB 

Address all communications to the Editor of the Journal, 
SOS Bankers Trust Building, Des Moines g 

OrnoB OP Publication, Des Moine^ 9, Iowa 

Vol. XXXV APRIL, 1945 No. 4 


COLLEGE OF MEDICINE DIAMOND JUBILEE 
ANNIVERSARY NUMBER 

This issue of the Journal is of special signifi- 
cance on two counts. First, it is the third con- 
secutive annual number in which all of the scien- 
tific articles have been prepared by the faculty of 
the College of Medicine at Iowa City. And sec- 
ond, as recorded on the opening page of this issue 
in the remarks of Dean MacEwen to the members 
of the Iowa State Medical Society, it is dedicated 
to commemorating the seventy-fifth, or diamond, 
anniversary of the founding of the School of 
Medicine. 

• For a number of reasons we are exceedingly 
pleased and prideful in being able to present this 
number to you — our readers. We feel it is an 
important means of bringing those of us engaged 
in private practice out over the state in closer con- 
tact with the teaching staff at our medical school. 
That the faculty of the College of Medicine has 
been similarly impressed is amply demonstrated by 
the willingness with which the members have pre- 
pared papers and by the excellence of the subject 
material they have presented. We are sure you 
will find it an interesting and valuable issue in- 
deed. We should like to take this opportunity of 
thanking Dean MacEwen, the committee who com- 
piled the material — Dr. Stuart Cullen and his asso- 
ciates, Dr. Sahs and Dr. Scheldrup — and the fac- 
ulty members who prepared manuscripts. So gen- 
erous were these latter that, regretfully, owing to 
paper limitations, we have been forced to hold over 
one manuscript for publication in the May issue. 

We would also call your attention to Dr. Walter 
Bierring’s article in the History of Medicine sec- 
tion where another birthdate — a golden anniver- 
sary — is celebrated. Fifty years ago in the De- 


partment of Pathology at the State University 
diphtheria antitoxin was first prepared in Iowa 
by Dr. Bierring. As one reads of this early expe- 
rience he can scarcely avoid reviewing in his 
mind’s eye the tremendous strides made by medi- 
cal science in the professional lifetime of one 
individual. 

We know, too, that this Diamond Jubilee num- 
ber of the Journal will be welcomed by the alumni 
of the College of Medicine in military service. 
We hope it reaches all of them wherever they 
may be. Many of them would be at Iowa City on 
September 27 and 28 to help Dean MacEwen and 
his faculty in the commemoration exercises for the 
Diamond Jubilee Anniversary were it not for their 
military obligations. While receipt of the Journal 
at some foreign port is at best a poor substitute 
to an Iowa alumnus for home, friends, and at- 
tendance in person at Iowa City, nevertheless it is 
something, and we can only hope that the hearts 
of some of our Iowa physicians will be gladdened 
a little as they read these articles by the teachers 
from their alma mater. 


ELLENDER BILL (S. 637) INTRODUCED TO 

ENSURE FUTURE SUPPLY OF PHYSICIANS 
AND DENTISTS 

On March 10 we received the following letter 
from your President, Dr. M. C. Hennessy. We 
are in entire agreement with his opinions and are 
happy to respond to his request. 

“I am enclosing a copy of the Ellender bill. I 
think the Iowa State Medical Society should sup- 
port this bill. If we do not, there is going to be 
a dearth of physicians when this war is over, and 
certainly, if in other communities in the state doc- 
tors who are now in practice at home are breaking 
down as they are in my community, I am positive 
there will be a shortage of medical men in Iowa. 
Our doctors here are doing a grand piece of work 
and they aren’t youngsters any more ; each day is 
taking something away from them, and I am sure 
this is true in other parts of the state, and so if you 
feel you can honestly support this bill to the ex- 
tent of writing an editorial for the Journal, I 
feel it would help pass it.” 

Below is reprinted in full S. 637 which has 
been introduced into the Senate of the United 
States Congress by Senator Allen J. Ellender of 
Louisiana and is now in the hands of the Commit- 
tee on Military Affairs. This bill should be passed 
by Congress. The Journal urges that every mem- 
ber of the Iowa State Medical Society communi- 
cate with his congressman in Washington to enlist 
support for its passage. 

Under present regulations of the Army’ and 
Navy only those physically unfit for military duty, 


VoL. XXXV, Xo. 4 


Journal of Iowa State Medical Society 


145 


discharged A'eterans, and women will be available 
for freshmen classes in medical schools in 1945. 
The result of this shortsighted policy in the sup- 
ply of physicians four years later may well be of 
disastrous proportions in the futune medical care 
of the nation. If, as is now proposed, a relatively 
large peacetime military force is maintained, many 
physicians will he required and will therefore not 
be available for civilian duty. The needs of veter- 
ans hospitals for physicians will be great. Further- 
more, the supply of civilian physicians is being 
depleted annually by some four thousand deaths 
plus many who are forced to retire by age or ill- 
ness. These are only the major sources which will 
operate to reduce the supply of doctors available 
for civilian duty in the postwar period. There 
are others. 

Senator Ellender’s bill aims at preventing this 
catastrophe. Should the war be prolonged, it 
would also provide for a supply of able-bodied 
doctors for military service. Please read the bill 
in its entirety and then communicate at once with 
your congressional representatives. It’s impor- 
tant ! 

A BILL 

To authorize the release of persons from active mili- 
tary service, and the deferment of persons from 

military service, in order to aid in making’ possible 

the education and training of physicians and den- 
tists to meet essential needs. 

Be it enacted by the Senate and House of Repre- 
sentatives of the United States of America in Con- 
gress assembled. That, to the extent that the Presi- 
dent deems to be (1) feasible, (2) compatible with 
military operations, and (3) necessary or desirable 
in order to make possible the education and training 
as physicians and dentists of as many persons as are 
necessai'y to provide the minimum number of medi- 
cal doctors and dentists required to meet the essen- 
tial needs of the civilian population (especially in 
rural areas) and the armed forces for medical and 
dental services in the future, the President is au- 
thorized to provide for the release from active duty 
in the armed forces of men who have completed more 
than one year of honorable service in such forces 
during the present war and who have satisfactorily 
completed a substantial portion of the medical, den- 
tal, premedical, or predental education and training 
necessary to qualify them as physicians or dentists, 
in order to enable such persons to pursue further 
such education and training. The release of any 
person from active duty for the purposes of this 
section may be conditioned upon his acceptance by 
an accredited school and the pursuit of such education 
and training in a satisfactoi’y manner. 

Sec. 2. Section 5 of the Selective Training and 
Service Act of 1940, as amended, is hereby amended 
by adding at the end thereof the following new sub- 
section: 

“(n) In order to make possible the education and 
training as physicians or dentists of as many persons 
as are necessary to provide the minimum number of 
medical doctors and dentists required to meet the 
essential needs of the civilian population (especially 
in rural areas) and the armed forces for medical or 
dental services in the future, the President shall, 
under such rules and regulations as he may pre- 
scribe, provide for the deferment from training and 
service under this Act in the land and naval forces 


of the United States of those men who are found in 
accordance with section 10 (a) (2) to be enrolled in 
the national medical and dental education program. 
The President shall provide for the enrollment, under 
such rules and regulations as he may prescribe, in 
a national medical and dental education pi’ogram 
(hereinafter referred to as the “program”) of such 
persons as he deems necessary to be enrolled in such 
program, in order that they may be defei'red under 
this subsection from training and service under this 
Act, subject to the following limitations: 

“(1) (A) The number of men enrolled in the pro- 
gram for the purpose of permitting them to pursue 
first-year premedical education and training shall 
not exceed eight thousand at any one time. 

“(B) The number of men enrolled in the program 
for the purpose of permitting them to pursue first- 
year predental education and training shall not ex- 
ceed three thousand five hundred at any one time. 

“(2) (A) The number of men enrolled in the pro- 
gram for the purpose of permitting them to pursue 
second year premedical education and training shall 
not exceed eight thousand at any one time prior to 
the end of the third month of the academic year 
and shall not exceed four thousand five hundred at 
any one time after the end of the third month of the 
academic year, and after the end of such third month 
shall not include anyone who has not been accepted 
for admission to the earliest subsequent entering 
class of an accredited medical school following the 
satisfactory completion of such second-year premedi- 
cal education and training. 

“(B) The number of men enrolled in the program 
for the purpose of permitting them to pursue second- 
year predental education and training shall not ex- 
ceed three thousand five hundred at any one time 
prior to the end of the third month of the academic 
year and shall not exceed one thousand seven hun- 
dred and fifty at any one time after the end of the 
third month of the academic yeai% and after the end 
of such third month shall not include anyone who 
has not been accepted for admission to the earliest 
subsequent entering class of an accredited dental 
school following the satisfactory completion of such 
second-year predental education and training. 

“(3) No man shall be enrolled in the program for 
the purpose of permitting him to pursue premedical 
or predental education and training for more than 
two years. 

“(4) (A) The number of men enrolled in the pro- 
gram for the purpose of permitting them to pursue 
first-year, second-year, third-year, or fourth-year 
medical education and training shall not exceed four 
thousand five hundred in each of such classes at any 
one time. 

“(B) The number of men enrolled in the pi’ogram 
for the purpose of permitting them to pursue first- 
year, second-year, third-year, or fourth-year dental 
education and training shall not exceed one thousand 
seven hundred and fifty in each of such classes at 
any one time.” 

In determining the number of men who may be en- 
rolled in the pi’ogram, the President shall take into 
considei’ation and make due allowances for the num- 
ber of physicians or dentists who may be obtained 
through the education and training of other persons 
not enrolled in the program, including veterans of 
the armed forces, women, and persons not qualified 
for military service. The limitation on the number of 
men who may be enrolled in the program shall not 
be deemed to be a limitation on the total number of 
students who may be enrolled in medical, dental, 
premedical, or predental schools; but shall be deemed 
to be a limitation only on the number of men who 
may be deferred under this subsection who shall be 
in addition to students who may be obtained from 
other sources. Persons shall not be enrolled in the 
program for the pui-pose of permitting them to pur- 


146 


Journal of Iowa State Medical Society 


sue medical oi* dental education and training at any 
schools except medical and dental schools whose 
graduates are acceptable to the armed forces for 
commissioning as medical doctors or dentists. The 
number of men who may be enrolled in the program 
for the purpose of permitting them to pursue each 
of the two respective years of premedical or pre- 
dental education and training shall be allocated by 
the President among the several states on the basis 
of population, as determined by the 1940 census. 
The men to be enrolled in the program from each 
state for the purpose of permitting them to pursue 
such education and training shall be selected from 
among applicants within such state, in such manner 
as the President may prescribe. In making such 
selections, representatives of accredited schools 
which offer full-time medical, dental, premedical, or 
pi'edental courses of instruction shall be consulted 
and their services may be utilized. No man who fails 
to make satisfactory progi’ess in pursuing his educa- 
tion and training shall be permitted to continue to 
be enrolled in the program. 


IMMUNE SERUM GLOBULIN AVAILABLE FOR 
PREVENTION AND MODIFICATION 
OF MEASLES 

The Journal is pleased to publish the following 
release on the use of immune serum globulin for 
prevention and modification of measles, which was 
received from the American Red Cross with the 
request that the information be disseminated as 
widely as possible among the doctors in Iowa: 

“Immune serum globulin for the prevention and 
modification of measles is now being distributed 
for civilian use by the American Red Cross, Chair- 
man Basil O’Connor announced recently. The 
expense of processing and distributing the material 
is being met by the Red Cross. 

“The immune serum globulin is derived from 
blood collected by the American Red Cross as a 
by-product in the processing of serum albumin, 
which is used by the armed forces. There is now 
more immune globulin available than is needed for 
military use, according to O’Connor. The navy, 
under whose control it is being produced, has re- 
leased the surplus of the crude material to the 
American Red Cross so that it can return to the 
people this valuable agent derived from the blood 
they have so generously given. 

“ ‘This product of human blood, which has been 
developed through wartime medical research, is 
the most valuable agent known for the prevention 
or modification of measles when administered to 
a susceptible individual within five days after ex- 
posure to the disease,’ said O’Connor. ‘It is neces- 
sary to inject only a small amount under the skin 
to modify measles, while a somewhat larger amount 
has been found to be almost 100 per cent effective 
in preventing the development of measles in an 
exposed individual. The protection furnished by 
the immune serum globulin, while temporary in 
character, is of great value in controlling out- 


April, 1945 

breaks and in preventing the dangerous complica- 
tions of the disease.’ 

“The immune serum globulin will be supplied 
by the American Red Cross without charge to state 
and territorial health departments or local health 
departments where biologies are not supplied by 
the state. They, in turn, will distribute it without 
charge to physicians, hospitals, and clinics for ad- 
ministration in accordance with established stand- 
ards and without any charge to the patient for the 
immune globulin.” 


DON’T NEGLECT CANCER* 

Never before have we been so aware of the life 
saving power of scientific research. Out of the 
laboratories and on to the firing line where millions 
of our young men are risking their lives, have gone 
sulfa drugs, penicillin, dried blood plasma. From 
the past we can take the names of killers conquered 
by science — yellow fever, smallpox, diphtheria, 
typhoid. 

Today research against cancer stands on the 
threshold of new and great advances. It has al- 
ready given us ways of producing and of control- 
ling the production of the disease in laboratory 
animals. It has begun to give us knowledge of 
how cancer cells differ from normal cells. 

But cancer research needs financial support and 
more trained workers. It must be given the mate- 
rial aid and security to make it efficient and in- 
creasingly powerful. 

Never before have we understood sO' well how 
to organize for the detection of precancerous con- 
ditions or to identify cancer in its early and cur- 
able stages. 

Few as yet realize the nature of the emergency 
which cancer presents. There are 17,000,000 liv- 
ing Americans who will die of cancer unless some- 
thing is done. There are at least 5,500,000 of them 
who can be saved from death from cancer by sim- 
ple, direct means. 

You who read this are one of the “means” by 
which these lives can be saved. Learn the danger 
signals that may mean cancer and the ways in 
which the risk of cancer may be decreased. Pass 
this information on to others. Enlist during April 
in the Field Army of the American Cancer Society. 
If one of the danger signals appears either in 
your own life or in that of a friend insist on prompt 
fearless action. Go to your doctor for examina- 
tion and advice. 

Education alone can save millions of lives even 
if research does not advance. No one can afford 
to be too busy to neglect this challenge. It is a 

♦Prepared by Clarence C. Little, D.Sc., Managing Director, 
American Cancer Society. 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


147 


choice between intelligent protection of yourself 
and those you love on the one hand, and ignorant 
risk of health, happiness and perhaps life itself, 
on the other. 

The American Cancer Society has been for over 
thirty years the one great national organization 
devoted to study and development of plans for can- 
cer control. It stands firmly on three fronts where 
it is face to face with the enemy — Research, Serv- 
ice, Education. It is going forward in support of 
all of these fields. It is going to take with it mil- 
lions of Americans, who realize the great need and 
their power to help. 

The American Cancer Society has a division of 
its Field Army in Iowa with headquarters in 
IMason City. Anyone desiring information may 
write i\Irs. C. iMcCarthy, Commander and 
Executive Director of the Iowa Field Army, at 
215 Second Street S. E., Mason City. 


FEDERAL REGULATION GOVERNING AD- 
MISSION TO THE CRIPPLED CHIL- 
DREN’S DIAGNOSTIC SERVICES 
AFTER JULY 1, 194.5 

The United States Children’s Bureau has for- 
warded the following communication to the 
Journal concerning regulations relating to services 
for crippled children : 

“Efifective July 1, 1945, it shall be a condition 
of approval of a plan that it provide that diagnostic 
services will be made available thereunder to 
crippled children without restrictions as to race, 
color, creed, economic status, legal residence, age 
(except as to persons above the maximum age 
for which such services are legally available within 
the State), the necessity of referral by any person 
other than the child’s parents or legal guardian, 
or similar restrictions inconsistent with the free 
availability of such services.” 

(Signed) Frances Perkins. 

Secretary. 

Miss Katharine F. Lenroot. Chief, Children’s 
Bureau, discusses the regulations in the following 
terms : 

In 1938 the Children’s Bureau Advisory Commit- 
tee on Services for Crippled Children made among 
others the following recommendations: 

(1) “That the State agencies make such provi- 
sions for diagnostic services as will permit the de- 
cision concerning eligibility for treatment to be 
based on the estimated cost of medical care in rela- 
tion to social and economic resources.” 

(2) “That State agencies assume final responsi- 
bility for detei-mination of eligibility and seek to 
eliminate court-commitment procedures.” 

The committee recognized, therefore, that in order 
for a State agency to reach an intelligent de- 
cision as to the need of a crippled child for care and 


treatment, it was essential that diagnostic services 
be provided so that the nature of the crippling con- 
dition, the type and amount of medical and surgical 
care indicated, and the estimated cost of providing 
the necessary care may be known and that this in- 
formation may be considered in relation to the so- 
cial and economic resources of the family as a basis 
for determining the child’s need for treatment 
services under the State program. Also the re- 
sponsibility for such determination is to rest with 
the agency that administers the State program 
and not with any other agency, organization, or 
individual. 

During the period of initial development of the 
State services for crippled children many State 
agencies included in their State plans provisions 
for certain eligibility requirements for the ad- 
mission of children to diagnostic clinics. In general, 
these requirements pertained to age, residence, and 
economic status and to referral of the child by a 
physician. 

Since 1938 the Children’s Bureau has sought to 
carry out the recommendations of its advisory com- 
mittee and the great majority of State agencies 
have adopted the recommendations with the result 
that the determination of eligibility for care and 
treatment is being made after appropriate medical 
diagnosis and after necessary social data have 
been obtained. The wisdom of following such a 
policy is more apparent at the present time than 
ever before in view of the widespread movement 
of families across State lines, the frequent lack of 
regular employment of the services of a “family” 
physician, and in some areas the unavailability of 
such services. 

In a few States, however, thei'e are still some re- 
quirements that a child must meet before his need 
for treatment services can be determined. A few 
States agencies, for example, make a preliminary in- 
vestigation of the financial situation of the family 
and may declare a child ineligible for care before 
the medical condition is actually known. This ap- 
pears to be an unsound procedure since the diag- 
nosis and approximate cost of treatment must be 
known in order to decide whether or not the family 
can meet these costs unaided. The requirement 
that a child must have lived in the given State or 
a given county for a period of months or years be- 
fore he can receive diagnostic services is a re- 
striction imposed by very few States; it is apparent 
that such a restriction may be extremely harmful 
to the crippled child by delaying necessary treat- 
ment. In a few States, the State agency has set 
up a requirement that a child can be seen in a 
State crippled children’s diagnostic clinic only if 
the child has been I’eferred to tbe clinic by a phy- 
sician. When, as a result of such a requirement, 
a child is barred from receiving an examination to 
determine his need for care, either because of the 
unavailability of a physician to make the referral, 
the reluctance on the part of the parent to I’equest 
a written referral, or for other similar reasons, it 
becomes apparent that such a requirement may be- 
come an obstacle to the child’s receiving the care 
and treatment he needs. The primary intent and 
purpose of the provisions under title V, part 2 of 
the Social Security Act is to locate crippled chil- 
dren and to assure to all crippled children found 
to be in need of care the services necessary to 
bring about the greatest degree of physical resto- 
ration and social adjustment that can be attained. 

The policy set forth in the Secretary’s regula- 
tion does not represent any departure from policies 
usually followed in comparable public programs of 
medical care. In many States, for example, serv- 
ices and facilities for the diagnosis of tuberculosis 
(Continued on page 155) 


148 


Journal of Iowa State Medical Society 


April, 1945 


COUNTY 

COUNTY MEDICAL SOCIETY OFFICERS 

PRESIDENT SECRETARY DEPUTY COUNCILOR 

Adair 

.R. E. Wiley, Fontanelle 

A. S. Bowers, Orient 

.A. S. Bowers, Orient 

Adams 

,A. W. Brunk, Prescott 

J. H. Wallahan, Corning 

. A. W. Brunk, Prescott 

Allamakee 

. J. W, Myers, Postville 

. J. W. Thornton, Lansing 

.J. W. Thornton, Lansing 

Appanoose 

.J. C. Donahue, Centerville 

C. F. Brummitt, Centerville 

. C. S. Hickman, Centerville 

Audubon 

.L. E. Jensen, Audubon 

W. H. Halloran, Audubon 

. L. E. Jensen, Audubon 

Benton 

.N. B. Williams, Belle Plaine. ... 

D. A. Dutton, Van Horne 

.N. B. Williams, Belle Plaine 

Black Hawk 

• H, A. Bender, Waterloo 

S. A. Barrett, Waterloo 

.A. J. Joynt, Waterloo 

Boone 

. A. B. Deering, Boone 

B. T. Whitaker. Boone 

.J. O. Ganoe, Ogden 

Bremer 

. 0. C. Hardwig, Waverly 

.M. N. Gernsey, Waverly 

.F. R. Sparks, Waverly 

Buchanan 

,H. A. Householder, Winthrop... 

J. W. Barrett, Jr., Independence. 

.J. W. Barrett, Jr., Independence 

Buena Vista 

. J. H. O’Donoghue, Storm Lake. , . 

■ T. R. Campbell, Sioux Rapids. . . . 

.H. E. Farnsworth, Storm Lake 

Butler 

,J. G. Evans, New Hartford 

.F. F. McKean, Allison 

. Bruce Ensley, Shell Rock 

Calhoun 

. ,P. W. Van Metre, Rockwell City.. 

.D. C. Carver, Rockwell City 

,R. G. Hinrichs, Manson 

Carroll 

. A. R. Anneberg, Carroll 

P. D. Anneberg, Carroll 

W. L. McConkie, Carroll 

Cass 

,G. A. Alliband, Atlantic 

R. L. Barnett, Atlantic 

.W. S. Greenleaf, Atlantic 

Cedar 

. Fred Montz, Lowden 

J. E. Smith. Clarence 

. P. M. Hoffman, Tipton 

Cerro Gordo 

. T. E. Davidson, Mason City 

R. E. Smiley, Mason City 

.G. J. Sartor, Mason City 

Cherokee 

. L. J. Spinharney, Cherokee 

D. C. Koser, Cherokee 

.C. H. Johnson, Cherokee 

Chickasaw 

.Nicholas Schilling, New Hampton 

J. E. Murtaugh, New Hampton.. 

.P. E. Gardner, New Hampton 

Clarke 

.F. S. Bowen, Woodburn 

. C. R. Harken, Osceola 

.H. E. Stroy, Osceola 

Clay 


C. C. Collester, Spencer 

.J. M. Sokol, Spencer 

Clayton 

P. R. V. Hommel, Elkader 

T. W. Lichter, Edgewood 

• P. R. V. Hommel, Elkader 

Clinton 

. R. E. Dwyer, Clinton 

. J. E. O’Donnell, Clinton 

.R. F. Luse, Clinton 

Crawford 

. E. V. Zaeske, Charter Oak 

.Dora E. K. Zaeske, Charter Oak. 

. C. L. Sievers, Denison 

Dallas-Guthrie 

. C. E. Porter, Redfield.... 

. S. J. Brown, Panora 

.E. J. Butterfield, Dallas Center 

Davis 

.C. H. Cronk, Bloomfield 

,H. C. Young, Bloomfield 

S. J. Brown, Panora 
.H. C. Young, Bloomfield 

Decatur 

•H. M. Hills, Lamoni 

.K. R. Brown, Lamoni 

F. A. Bowman, Leon 

Delavi’are 

. C. B. Rogers, Earlville 

Paul Stephen, Manchester 

.J. K. Stepp. Manchester 

Des Moines 

. D. F. Huston, Burlington 

W. R. Lee, Burlington 

.F. G. Ober, Burlington 

Dickinson 

■T. L. Ward, Arnolds Park 

Ruth F. Wolcott, Spirit Lake... 

.T. L. Ward, Arnolds Park 

Dubuque 

.H. E. Thompson, Dubuque 

J. W. Lawrence, Dubuque 

.J. C. Painter, Dubuque 

Emmet 

.•S. C. Kirkegaard, Estherville. . . 

L. W. Loving. Estherville 

. S. C. Kirkegaard, Estherville 

Fayette 

• A. F. Grandinetti, Oelwein 

Elizabeth S. Kennedy, Oelwein . . 

. C. C. Hall, Maynard 

Floyd 

. C. H. Cords, Rudd 

R. A. Fox, Charles City 

.R. A. Fox, Charles City 

Franklin 

•J. C. Powers, Hampton 

. F. L. Siberts, Hampton 

.J. C. Powers, Hampton 

Fremont 

■ Ralph Lovelady, Sidney 

A. E. ’Wanamaker, Hamburg 

.A. E. Wanamaker, Hamburg 

Greene 

• «L. C. Nelson, Jefferson 

J. R. Black, Jefferson 

.L. C. Nelson, Jefferson ■ 

Grundy 

• C. H. BartrufE, Reinbeck 

. G. A. Biebesheimer, Reinbeck.... 

. W. 0. McDowell, Grundy Center 

Hamilton 

• R. C. Crumpton, Webster City. . . . 

M. B. Galloway, Webster City... 

.M. B. Galloway, Webster City 

Hancock-Winnebago. 

• C. V. Hamilton, Garner 

W. F. Missman, Klemme 

. C. V. Hamilton, Gamer 

Hardin 

• D. M. Nyquist, Eldora 

W. E. Marsh, Eldora 

G. F. Dolmage, Buffalo Center 
.F. N. Cole, Iowa Falls 

Harrison 

Henry 

• R. H. Cutler, Little Sioux 

. S. W. Huston, Mt. Pleasant 

,F. H. Hanson, Magnolia 

J. S. Jackson, Mt. Pleasant 

.S. W. Huston, Mt. Pleasant , 

Howard 

•W. A. Bockoven, Cresco 

,F. E. Giles, Cresco 

,W. A. Bockoven, Cresco 

Humboldt 

. C. A. Newman, Bode 

, R. W. Beardsley, Livermore 

.1. T. Schultz. Humboldt 

Ida 

. E. S. Heilman, Ida Grove 

W. P. Crane, Holstein 

.E. S. Parker, Ida Grove 

Iowa 

. L. A. Miller, North English 

I. J. Sinn, Williamsburg 

.1. J. Sinn. Williamsburg 

Jackson 

• E. V. Andrew, Maquoketa 

J. J. Tilton, Maquoketa 

. F. J. Swift, Maquoketa 

Jasper 

• R. F. Freeh, Newton 

.T. D. Wright, Newton 

.R. W. Wood, Newton 

Jefferson 

.L. D. James, Fairfield 

I. N. Crow, Fairfield 

.1. N. Crow, Fairfield 

Johnson 

. M. L. Floyd, Iowa City 

R. H. Flocks, Iowa City 

. G. C. Albright, Iowa City 

Jones 


C. R. Smith, Onslow 

.'T. M. Redmond, Monticello 

Keokuk 

• T. J. G. Dulin, Sigourney 

John Maxwell, What Cheer 

.C. L. Heald, Sigourney 

Kossuth 

• P. V. Janse, Algona 

.M. G. Bourne, Algona 

J. G. Clapsaddle, Burt 

Lee 


H. F. Noble, Fort Madison 

. R. L. Feightner, Ft. Madison 

Linn 

• B. J. Moon, Cedar Rapids 

D. S. Challed, Cedar Rapids 

B. L. Gilfillan, Keokuk 
.B. F. Wolverton, Cedar Rapids 

Louisa 

•J. W. Pence, Columbus Junction. 

,L. E. Weber, Wapello 

.J. H. Chittum, Wapello 

Lucas 

■ H. D. Jarvis, Chariton 

R. E. Anderson, Chariton 

. S. L. Throckmorton, Chariton 

Lyon 

J. H. Sherlock, Rock Rapids 

.G. M. DeYoung, George 

Madison 

. H. E. Carver, Earlham 

. E. M. Olson, Winterset 

.C. B. Hickenlooper. Winterset 

Mahaska 

.C. N. Bos, Oskaloosa 

F. A. Gillett. Oskaloosa 

. L. F. Catterson, Oskaloosa 

Marion 

. F. M. Roberts, Knoxville 

. E. C. McClure, Bussey 

E. C. McClure, Bussey 

Marshall 

.B. S. Wells, Marshalltown 

G. M. Johnson. Marshalltown... 

.A. D. Woods, State Center 





Mitchell 

. G. E. Krepelka, Osage 

J. 0. Eiel, Osage 


Monona 

E. J. Liska, Ute 

E. E. Gingles, Onawa 

,C. W. Young, Onawa 

Monroe 

.J. F. Stafford, Lovilia 

. T. A. Moran, Melrose 

. T. A. Moran, Melrose 

Montgomery 

. L. R. Moriarty, Villisca 

Helge Borre, Red Oak 

. Oscar Alden, Red Oak 

Muscatine 

, JL. C. Howe, Muscatine 

J. L. Klein, Jr., Muscatine 

.T. F. Beveridge, Muscatine 

O’Brien 

,C. A. Samuelson, Sheldon 

.W. S. Balkema, Sheldon 

.W. R. Brock, Sheldon 

Osceola 

.H. B. Paulsen, Harris 

W. F. Thayer, Ocheyedan 

.Frank Reinsch, Ashton 

Page 

. N. M. Johnson, Clarinda 

J. F. Aldrich, Shenandoah 

. W. H. Maloy, Shenandoah 

Palo Alto 

J. P. McManus, Graettinger 

P. 0. Nelson, Emmetsburg 

,H. L. Brereton, Emmetsburg 

Plymouth 

.M. J. Joynt, Le Mars 

L. C. O’Toole, Le Mars 

.W. L. Downing, Le Mars 

Pocahontas 

. W. F. Brinkman, Pocahontas.... 

G. A. Everson, Rolfe 

.J. H. Hovenden, Laurens 

Polk 

.A. E. Merkel, Des Moines 

E. W. Anderson, Des Moines 

.J. B. Synhorst, Des Moines 

Pottawattamie 

. F. E. Marsh, Council Bluffs 

.G. V. Caughlan, Council Bluffs. . . 

.G. N. Best, Council Bluffs 

Poweshiek 

. H. C. Parsons, Grinnell 

C. E. Harris, Grinnell 

.C. E. Harris, Grinnell 

Ringgold 

. .0. L. Fullerton, Redding 

,J. W. Hill, Mt. Ayr 

.E. J. Watson, Diagonal 

Sac 

..A. A. Blum, Wall Lake 

J. W. Gauger, Early 

.J. R. Dewey, Schaller 

Scott 

. A. A. Garside, Davenport 

L. J. Miltner, Davenport 

.A. P. Donohoe, Davenport 

Shelby 

.J. P. McGowan, Harlan 

A. L. Nielson, Harlan 

. A. L. Nielson, Harlan 

Sioux 

.A. L. Lock, Rock Valley 

,Wm. Doornink, Orange City.... 

.Wm. Doornink, Orange City 

Story 




Tama 

. .G. T. McDowall, Gladbrook 

G. M. Dalbey, Traer 


Taylor 

.C. E. Buckley, Blockton 

J. H. Gasson, Bedford 

.G. W. Rimel, Bedford 

Union 

. J. A. Liken, Creston 

. C. C. Rambo, Creston 

. C. C. Rambo, Creston 

Van Buren 

. Roscoe Pollock, Douds-Leando. . . 

.J. A. Craig, Keosauqua 

.L. A. Coffin, Farmington 

Wapello 

. S. F. Singer, Ottumwa 

.L. A. Taylor, Ottumwa 

. E. B. Hoeven, Ottumwa 

Warren 

.G. A. Jardine, New Virginia.... 

. C. H. Mitchell, Indianola 

.C. H. Mitchell, Indianola 

Washington 

.W. L. Alcorn, Washington 

. W. S. Kyle, Washington 

• E. D. Miller, Wellman 

Wayne 

. ,D. R. Ingraham. Sewal 

.C. F. Brubaker, Corydon 

.L. B. Calbreath, Humeston 

Webster 

. T. J. Dorsey, Fort Dodge 

P. C. Otto, Fort Dodge 

.H. E. Nelson. Dayton 

Winneshiek 

. R. M. Dahlquist, Decorah 

H. H. Ennis, Decorah 

. L. C. Kuhn, Decorah 

Woodbury 

. C. A. Katherman, Sioux City.... 

F. D. McCarthy, Sioux City 

. D. B. Blume, Sioux City 

Worth 

.B. H. Oaten, Northwood 

. M. P. Allison. Northwood 

.S. S. Westly. Manly 

Wright 

. B. L. Basinger, Goldfield 

. J. R. Christensen, Eagle Grove. . . 

. J. H. Sams, Clarion 4-1-45 



VoL. XXXV, No. 4 


Journal of Iowa State Medical Society , 


149 



As of March 24, 1945 


Adair County 

Cornell, D. D., Greenfield (APO 41, San Francisco, 

Cal.) Capt., A.U.S. 

Gantz, A. J., Greenfield (APO 951, San Francisco. 

Cal.) Capt., A.U.S. 

Adams County 

Bain, C. L., Corning (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Willett, W. J.. (larbon (APO 230, New York, N. Y.) .Capt., A.U.S. 


Allamakee County 
Hogan, P. W., Waukon 

Ivens, M. H., Waukon (Miami Beach, Fla.) Capt., A.U.S. 

Kiesau, M. F.. Postville (Jefferson Barracks, Mo.).. Major, A.U.S. 

Rominger, C. R., Waukon (Camp Claiborne, La.) A.U.S. 

Appanoose County 

Condon, F. J., Centerville (Owensboro, Ky.) . .Major, U.S.P.H.S. 

Edwards, R. R., Centerville (Richmond, Va.) Capt., A.U.S. 

Huston, M. D., Centerville (Camp Bowie, Texas) .. Capt., A.U.S. 


Audubon County 

Koehne, F. D., Audubon (APO 520, New York, 

N. Y.) Major, A.U.S. 


Benton County 

Koontz, L. W., Vinton (APO 7, San Francisco, Cal.) Capt., A.U.S. 

Senfeld, Sidney, Belle Plaine 

Black Hawk County 

Bickley, D. W., Waterloo (APO New York, N. Y.) .Capt., A.U.S. 

Bickley, J. W., Waterloo (APO 956, San FVancisco, 

Cal.) Capt., A.U.S. 

Butts. J.. H.. Waterloo (Galveston, Texas) Comdr., U.S.N.R, 

Cooper, C. N., Waterloo Lt. Comdr., U.S.N.R. 

Ericsson, M. G., Cedar Falls (Camp Barkeley, Tex.) Capt., A.U.S. 

Hartman, H. J., Waterloo (APO 33, San Francisco, 

Cal.) Capt., A.U.S. 

Henderson, L. J., Cedar Falls (APO 782, 

New York, N. Y.) Major, A.U.S. 

Hoyt, C. N., Cedar Falls (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Ludwick, A. L., Waterloo (Abilene, Texas) Major, A.U.S. 

Marquis, F. M., Waterloo (APO 613, New York 
N. Y.) Capt., A.U.S. 

O’Keefe, P. T., Waterloo (APO 79, New York, 

N. Y.) Capt., A.U.S. 

Paige, R. T., LaPorte City (Banana River, -Ela.) .Comdr., U.S.N.R. 

Rohlf, E. L., Jr., Waterloo (APO 230, New York, 

N. Y.) Major, A.U.S. 

Seibert, C. W., Waterloo (Colorado Springs, Colo.) . .Major, A.U.S. 

Smith, E. E., Waterloo (APO 709, San Francisco, Cal.) 

Major, A.U.S. 

Smith, R. I.. Waterloo (Milwaukee, Wis.) Capt., A.U.S. 

Smith. R. G., Cedar Falls (APO 612, New York, 

N. Y.) Major, A.U.S. 

Trunnell, T. L., Waterloo (Parris Island, S. Car.) .. .Lt. U.S.N.R. 

Boone County 

Brewster. E. S., Boone (APO 446, New York, N. Y.) .Major, A.U.S. 

Healy, M. J., Boone (Fort Sill, Okla.) Capt., A.U.S. 

Shane, R. S., Pilot Mound (Des Moines, la.) Lt. Col., A.U.S. 

Bremer County 

Blum, O. S., Waverly (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Rathe, H. W., Waverly (APO 209, New York, N. Y.) 

Lt. Col., A.U.S. 

Shaw, R. E., Waverly (Long Beach, Cal.) 1st Lt., A.U.S. 

Buchanan County 

Barton, J. C., Independence (APO 314, New York, 

N. Y.) Lt. Col., A.U.S. 

Hersey, N. L., Independence (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Leehey, P. J., Independence (APO 244, San PYancisco, 

Cal.) Capt., A.U.S. 

Loeck, J. F., Aurora (APO 9787, New York, N. Y.) . .Capt., A.U.S. 


Buena Vi.sta County 

Almquist, R. E., Albert City (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Brecher, P. W., Storm Lake (Camp Adair, Ore.) . .Lt. Col., A.U.S. 

Hansen, R. R., Storm Lake (Farragut, Idaho) Lt., U.S.N.R. 

Mailliard, R. E.. Storm Lake (APO 264, New York, 

N. Y.) Lt. Col., A.U.S. 

Shope, C. D., Storm Lake (Fort Des Moines. la.) .. Capt., A.U.S. 
Witte, H. J„ Marathon (APO 350, New York, 

N. Y.) Major, A.U.S 

Butler County 


Andersen, B. V., Greene (San Diego, Cal.) Lt., U.S.N.R. 

James, R. A., Allison (Mare Island, Cal.) 

Rolfs, F. 0„ Parkersburg (Springfield. Mo.) 1st Lt., A.U.S. 


Calhoun County 

Grinley, A. V., Rockwell City (APO 350, New York. 


N. Y.) Capt., A.U.S. 

Hobart, F. W.. Lake City (Camp Grant, 111.) Capt., A.U.S. 

McVay, M. J.. L«ke City (Waco, Texas) Capt., A.U.S. 


Peek, L. H., Lake City (Jefferson Barracks, Mo.) . .Capt., A.U.S. 
Stevenson. W. W., Rockwell City (Fleet PO, San 


Francisco, Cal.) Comdr., U.S.N.R. 

Weyer, J. J., Lohrville (APO 466, New York, 

N. Y.) Capt., AU.S. 

Carroll County 

Anneberg, A. R., Carroll (Camp Barkeley, Texas) A.U.S. 

Anneberg, W. A., Carroll (APO 367, New York, 

N. Y.) Capt., A.U.S. 

Cochran, J. L., Carroll (Gulfport, Miss.) 

Cross, D. L., Coon Rapids (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Freedland, Maurice, Coon Rapids 

Morrison, J. R., Carroll (Ft. Dix, N. J.) Capt., A.U.S. 

Morrison, R. B., Carroll (APO 634, New York, 

N. Y.) Capt., A.U.S. 

Pascoe, P. L„ Carroll (Bowman Field, Ky.) Capt., A.U.S. 

Scannell, R. C., Carroll (Denver, Colo.) Capt., A.U.S. 

Tindall, R. N., Coon Rapids (Hines, 111.) Major, A-U.S. 

Wyatt, M. R., Manning (Stuttgart, Ark.) Capt., A.U.S. 


Cas8 County 

Egbert, D. S., Atlantic (APO 218, New York N. Y.) 

Major. A.U.S. 

Ergenbright, W. V., Atlantic (APO 957, San Fran- 


cisco, Cal.) Capt., A.U.S. 

Needles, R. M., Atlantic (APO 131, New York, 

N. Y.) Capt., A.U.S. 

Petersen, M. T., Atlantic (Topeka, Kan.) Capt., A.U.S. 

Schiff, Joseph, Anita (Rochester, Minn.) 1st Lt., A.U.S. 

Cedar County 

Laughlin, R. M., Tipton (San Diego, Cal.) Lt., U.S.N.R, 

Mosher, M. L., West Branch (APO 560, New York, 

N. Y.) Capt., A.U.S. 

O’Neal, H. E., Tipton (Minneapolis, Minn.) Lt. Col., A.U.S. 


Cerro Gordo County 


Adams, C. O., Mason City (Vancouver, Wash.) ... .Major, A.U.S. 

Egloff, W. C., Mason City (APO 17130, New York, 

N. Y.) Capt., A.U.S. 

Flickinger, R. R., Mason City (Memphis, Tenn.) ... .Capt., A.U.S. 

Hale, A. E., Dougherty (Atlanta, Ga.) Capt., A.U.S. 

Harris, R. H., Mason City (Dyersburg, Tenn.) Capt., A.U.S. 

Harrison, G. E„ Mason City (APO 365, New York, 

^N. Y.) Col., A.U.S. 

Houlahan, J. E., Mason City (APO 838, New Orleans, 

La.) Capt., A.U.S. 

Lannon, J. W., Clear Lake (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Long, D. L., Mason City (APO 620, New York, 

, N. Y.) Capt., A.U.S. 

Morgan. P. W., Mason City (Camp Butner, 

N. Car.) Capt., A.U.S. 

Sternhill, Irving, Mason City (Ayer, Mass.) Capt., A.U.S. 

Cherokee County 

Bullock, G. D., Washta (APO 17683, New York, 

N. Y.) Capt., A.U.S. 

Ihle, C. W., Jr., Cleghorn (APO 6, San Francisco, 

Cal.) Major, A.U.S. 

Swift, C. H., Jr., Marcus (APO 201, San Francisco, 

Cal.) Capt., A.U.S 


Chickasaw County 

Caulfield, J. D., New Hampton (APO 178, New York, N. Y.) 

Major, A.U.S. 

Murphey, A. L., Fredericksburg (Ft. Leavenworth, 

Kan.) Capt., A.U.S. 

O’Connor, E. C., New Hampton (Redmond, Ore.) .. .Capt., A.U.S. 

Richmond, P. C., New Hampton (APO 88, New York, 

N. Y.) Major, A.U.S 

Clarke County 

Armitage, G. I., Murray (APO 629, New York, 

N. Y.) Capt., A.U.S. 

Clay County 

Edington, F, D., Spencer (APO 649, New York, 

N. Y.) Col., A.U.S. 

Jones, C. C., Spencer (Farragut, Idaho) Lt., U.S.N.R. 

King. D. H.. Spencer (Peterson Field, Colo.) Capt., A.U.S. 

Clayton County 

Andersen, H. M., Strawberry Point (Camp Crowder, 

Mo.) Capt., A.U.S. 

Glesne, O. G., Monona (Knoxville, Iowa) Capt., A.U.S. 

Rhomberg, E. B., Guttenberg (APO 684, New York, 

N. Y.) Capt., A.U.a 

Clinton County 

Amesbury, H. A., Clinton (Vancouver, Wash.) ... .Major, A.U.S. 

Burke, J. C., Clinton (Great Bend, Kan.) A.U.S. 

Ellison. G. M., Clinton (APO 9030, New York, 

N. Y.) Capt., A.U.S. 

Hill. D. E., Clinton (APO 9787, New York, N. Y.) . . .Capt., A.U.S. 

King, R. C., Clinton (Clinton. Iowa) Capt., A.U.S. 

Lenaghan, R. T., Clinton (Olathe, Kans.)...Lt. Comdr., U.S.N.R. 


150 


JocKNAL OF Iowa State Medical Society 


April, 1945 


Norment, J. E., Clinton (Washington, D. C.) 

Lt. Comdr., U.S.N.R. 

Riedesel, E. V., Wheatland (Fort Douglas, Utah) 

Scanlan, G. C.. DeWitt (Carlisle Barracks, Pa.) . . . . Capt., A.U.S. 
Snyder, D. C., De Witt (APO 520, New York, N. Y.) .Capt., A.U.S. 

Speigel, I. J., Clinton (Galesburg, 111.) Capt., A.U.S. 

Van Epps, E. F., Clinton (APO 0921, New York, 

N. Y.) Capt., A.U.S. 

Waggoner, C. V., Clinton (Fleet PO, San FYancisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Wells. L. L., Clinton (APO 662, New York, N. Y.) . .Capt., A.U.S. 
Crnwford County- 

Fee, C. H., Denison (APO 696, New York. N. Y.) .Major, A.U.S. 
Grau, A. H., Denison, (Fleet PO, San Francisco. 

Cal.) Lt. Comdr., U.S.N.R. 

Maire, E. J., Vail (APO 18086, New York, N. Y.) . . .Capt., A.U.S. 
Wetrich, M. F., Manilla (APO 986. Seattle, Wash.) . .Capt., A.U.S 


Dallas-Guttarle Counties 

Butterfield, E. T., Dallas Center (Fort Sheridan, 

111.) 1st Lt., A.U.S. 

Byrnes, A. W., Guthrie Center (Fort Custer, Mich.) .Major. A.U.S. 

Fail, C. S., Adel (Fleet PO, San Francisco, Cal.) . . . .Lt U.S.N.R. 

Margolin, J. M., Perry (APO 5816, New York, 

N. Y.) Capt., A.U.S. 

McGilvra, R. I., Guthrie Center (Ames, Iowa) Lt., U.S.N.R. 

Mullmann, A. J., Adel (APO 565, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Nicoll, C. A., Panora (AP'O 349, New York, N. Y.) . .Major, A.U.S. 

Osborn, C. R., Dexter (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Todd, D. W., Guthrie Center (APO 2, New York, 

N. Y.) Capt., A.U.S. 

Wilke, F. A„ Woodward Capt., A.U.S. 

Davis County 

Fenton, C. D„ Bloomfield (APO 5253, New York, 

N. Y.) ....Capt., A.U.S. 

Gilfillan, G. W., Bloomfield (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 


Decatur County 

Garnet, E. E., Lamoni (APO New York, N. Y.) Capt., A.U.S. 

Delaware County 

Baumgarten, Oscar, Earlville (APO 689, New York, 

N. Y.) Capt., A.U.S. 

Clark, R. E., Manchester (APO 419, New York, N. Y.) 

Capt., A.U.S. 

Des Moines County 

Eigenfeld, M. L., Burlington (Cleveland, Ohio) .. .1st Lt., A.U.S. 

Heitzman, P. O., Burlington (Fort Lewis, Wash.) . . .Capt., A.U.S. 

Jenkins, G. D,, Burlington (West Point, N. Y.) ,, ,Lt. Col., A.U.S. 

Lohmann, C. J., Burlington (APO 708, San Fran- 
cisco, Cal.) Major, A.U.S. 

McKitterick, J. C., Burlington (Hamilton, 

R. I.) Comdr., U.S.N.R. 

Moerke, R. F., Burlington (APO 665, San Francisco, 

Cal.) Capt., A.U.S. 

Sage, E. C., Burlington (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Dickinson County 

Buchanan, J. J., Milford (Santa Ana, Cal.) Lt., U.S.N.R. 

Henning, G. G., Milford (APO 96, San Francisco, 

Cal.) Major, A.U.S. 

Nicholson, C, G,, Spirit Lake (Sawtelle. Cal.) Capt., A.U.S. 

Rodawig, D. F., Spirit Lake (Topeka, Kan.) Major, A.U.S. 

Dubuque County 

Anderson, E. E., Dubuque (Bradley Field, Conn.) Capt., A.U.S. 

Beddoes, M. G., Cascade (APO 709, San Francisco, 

Cal.) Capt., A.U.S. 

Conzett, D. C., Dubuque (APO 887, New York, 

N. Y.) Lt. Col., A.U.S. 

Cunningham, J. C., Dubuque (Fairfield, Ohio) Capt., A.U.S. 

Edstrom, Henry, Dubuque (APO 645, New York, N. Y.) 

Major, A.U.S. 

Entringer, A. J., Dubuque (APO 41, San Francisco, 

Cal.) Capt., A.U.S. 

Hall, C. B., Dubuque (Indiantown Gap, Pa.) Capt., A.U.S. 

Knoll, A. H,, Dubuque (San Francisco, Cal,) Major, A,U.S. 

Langford, W. R., Epworth (Miami Beach, Fla.) .., .Capt., A.U.S, 

Lavery, H. B., Dubuque (Washington, D. C.) Lt. Col., A.U.S. 

Leik, D. W., Dubuque (Wichita Falls, Tex.) Capt., A.U.S. 

Mueller, J. J., Dubuque (APO 230, New York, N. Y.) .Capt., A.U.S. 

Olson, P. F., Dubuque (Mare Island, Cal.) . .Lt, Comdr., U.S.N,R, 

Painter, R. C„ Dubuque (Salt Lake City, Utah) Lt., U.S.N.R. 

Paulus, J. W., Dubuque (APO 115, New York, 

N. Y.) Capt., A.U.S. 

I lankers, A. G., Dubuque (APO 363 New York, 

N. Y.) Lt. Col., A.U.S. 

Quinn, E. P,, Dubuque (Brooklyn, N. Y.) Major, A.U,S. 

Scharle, Theodore, Dubuque (APO 17570, New York, 

N. Y.) Capt„A,U,S. 

Schueller, C. J„ Dubuque (APO 768, New York, 

N. Y.) 1st Lt„ A.U.S. 

Sharpe, D. C., Dubuque (APO 5541, New York, 

N. Y.) Major, A,U.S. 

Smith, C. W„ Dubuque (Shoemaker, Cal.) Lt., U.S.N.R. 

Steffens, L. F., Dubuque (Camp Chaffee, Ark.) ,.. Lt. Col., A.U.S. 

Straub, J. J., Dubuque (Bethesda, Md.) Lt. Comdr,, U.S.N.R. 

Ward, D. F., Dubuque ((3reat Lakes, HI.) . . . .Lt. Comdr., U.S.N.R. 


Elmmet County 

Clark, J. P., Estherville (APO New York, N. Y,) , .Capt,, A.U,S. 

Collins, L. E., Estherville (APO 247, San Fran- 
cisco, Cal.) 1st Lt., A.U.S. 

Miller, O. H., Estherville (Seattle, Wash.)..Lt. Comdr., U.S,N,R. 

Fayette Connty 

Gallagher, J. P., Oelwein (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Henderson, W. B., Oelwein (St. Louis, Mo.) Lt Col., A.U.S. 

Sulzbach, J. F., Oelwein 

Walsh, W. E., Hawkeye (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R 

Floyd Coonty 

Baltzell, W. C., Charles City (APO 2, New York, 

N. Y.) Major, A.U.S. 

Flater, N. C., Floyd (APO 360. New York, N. Y.) .Capt., A.U.S. 

Knight, R. A., Rockford (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Mackie, D. G., Charles City (APO 216, New York, 

N. Y.) Capt., A.U.S. 

Miner, J. B., Jr., Charles City (San Diego, Cal.) .. .Lt., U.S.N.R. 

Tolliver, H. A., (jharles City (APO 91, New York, N. Y.) 
Capt., A.U.S. 

Franklin County 

Byers. W. L.. Sheffield (Jefferson Barracks, Mo.) 1st Lt., A.U.S. 

Hedgecock, L. E., Hampton (Camp Lejeune, 

N. Car.) Lt. Comdr., U.S.N.R. 

Randall, W. L., Hampton (Oceanside, Cal.) Lt,, U.S.N.R. 

Walton, S, G,, Hampton (APO New York, N, Y,) . , .Capt., A,U.S. 

Fremont Connty 

Kerr, W. H., Hamburg (APO 926, San FYancisco, 

Cal.) Capt., A.U.S. 

Marrs, W. D., Tabor (Ardmore. Okla.) Capt., A.U.S. 

Powell, R. A., Farragut (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R 

Wanamaker, A. R., Hamburg (APO 939, Seattle, 

Wash.) Capt., A.U.S. 

Greene County 

Cartwright, F. P., Grand Junction (APO 511, New York, 

N. Y.) Capt., A.U.S. 

Castles, W. A., Rippey (APO 968, San Francisco, Cal.) 

Major, A.U.S. 

Hanson, L. C., Jefferson (APO 728, New York, N. Y.) 
Capt., A.U.S. 

Jongewaard, A. J., Jefferson (Fleet PO, San 

Francisco, Cal.) Lt. Comdr., U.S.N.R. 

Limburg, J. I., Jr., Jefferson (APO 927, San Francisco, 

Cal.) Major, A.U.S. 

Lohr, P. E., Churdan (Hastings, Nebr.) Lt,, U,S,N.R. 

Grundy County 

Cullison, R, M., Dike (Fort Howard, Md.) Major, A.U.S. 

Rose, J. E„ Grundy Center (Fleet PO, New York, 

N. Y.) Lt. Comdr., U.S.N.R. 

Hamilton Connty 

*Buxton O. C., Webster City (APO 9921, New York, 

N. Y.) 1st Lt., A.U.S. 

Howar, B. F., Jewell (APO 514, New York, N. Y.) Major, A.U.S. 

James, D. W., Kamrar (APO 370, New York, N. Y.) 

Capt., A.U.S. 

Lewis, W. B., Webster City (APO 383, New York, 

N. Y.) Major, A,U.S. 

Mooney, F. P,, Jewell (London, England) Capt., R.A.M.C. 

Paschal, G, A., Williams (Camp Crowder, Mo,) Capt., A.U.S. 

Patterson, R. A., Webster City (San Diego, 

Cal.) Lt. Comdr., U.S.N.R 

Ptacek, J. L., Webster City (APO 12845 G, New York, 

N. Y.) Capt„A.U.S. 

Schrader, M. A„ Webster City (Topeka, Kan.) 1st Lt., A.U.S. 

Thompson, E. D., Webster City (Biloxi. Miss.) Capt., A.U.S. 

Hancock-Winnebngro Counties 

Dolmage, G. H., Buffalo Center (Denver, Colo.) Capt., A.U.S. 

Dulmes, A. H., Klemme (APO 782, New York, 

N. Y.) Capt., A.U.S. 

Eller, L. W., Kanawha (APO 302, New York, 

N. Y.) Capt., A.U.S. 

Irish, T. J., Forest City (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Shaw, D. F„ Britt (Delhart, Tex.) Major, A.U.S. 

Thomas, C. W., Forest City (Camp Crowder, Mo.) . .Capt., A.U.S. 

Hardin Connty 

Burgess, A. W., Iowa Falls (Jacksonville. Fla.) Lt., U.S.N.R 

Houlihan, F. W., Ackley (APO 860, New York, 

N. Y.) 1st Lt.. A.U.S. 

Jansonius, J. W., Eldora (APO 4834, New York, 

N. Y.) Capt., A.U.S. 

Johnson, R. J., Iowa Falls (APO 514, New York, 

N. Y.) Capt, A.U.S. 

Johnson, W. A., Alden (Orlando, Fla.) Capt., A.U.S. 

Shurts, J. J., Eldora (Camp Roberts, Cal.) 1st Lt., A.U.S. 

Steenrod, E. J., Iowa Falls (Fleet PO. San Francisco, 

Cal.) Lt., U.S.N.R 

Todd, V. S., Eldora (APO 70, San Francisco, Cal.) . .Capt., A.U.S. 

Harrison County 

Bergstrom, A. C., Missouri Valley (PT. Ord, Cal.) .. .Capt., A.U.S. 

Burbridge, G. E., Logan (APO 611, New York, 

N. Y.) Major, A.U.S. 

Byrnes, C. W., Dunlap (APO 980, Seattle, Wash.) . .Capt., A.U.S. 

Heise, C. A., Jr., Missouri Valley (Fleet PO, San 

Francisco, Cal.) Lt., U.S.N.R 

Tamisiea, F. X., Missouri Valley (APO 662, New York, 

N. y.) Capt., A.U.3. 

Henry County 

Brown, W. B., Mount Pleasant (APO 671, New York, 

N. Y.) Major, A.U.S. 


VoL. XXXV, No. 4 


151 


Journal of Iowa State ^Medical Society 


Dwankowski, Carl, Mt. Pleasant (APO 611, 

New York, N. Y.) Capt., A.U.S. 

Gloeckler, B. B., Mount Pleasant (APO 9768, New York, 

N. Y.) Capt., A.U.S. 

Hartley, B. D., Mount Pleasant (APO 17130, New 
York, N. Y.) Capt., A.U.S. 

Megorden, W. H., Mount Pleasant (Ogden, Utah) . .Capt., A.U.S. 

Ristine, ll P., Mount Pleasant (APO 9648, New York, 

N. Y.) Major. A.U.S. 

Howard County 

Buresh, Abner, Lime Springs (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Nierling, P. Cresco (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Humboldt County 

Arent, A. S., Humboldt (Stockton, Cal.) Capt., A.U.S. 

Coddington, J. H., Humboldt (Oklahoma City, Okla.) .Capt., A.U.S. 

Ida County 

Dressier, J. B., Ida Grove (APO 713, Unit 2, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Martin, J. W., Holstein (Albany, Ga.) Capt., A.U.S. 

Iowa County 

Geiger, U. S., North English (San Diego, 

Cal.) Lt. Comdr., U.S.N.R. 

McDaniel, J. D., Marengo (Fort Ord, Cal.) Capt., A.U.S. 

Miller, D. F., Williamsburg (Fleet PO, San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

Jackson County 

Bausch, R. G., Bellevue (APO 251, New York, 

N. Y.) Capt., A.U.S. 

Skelley. P. B., Jr., Maquoketa (Ft. Lewis, Wash.) . .1st Lt., A.U.S. 

Swift, F. J., Jr., Maquoketa (APO 662, New York, 

N. Y.) Major, A.U.S. 

Jasper County 

Doake, Clarke, Newton 1st Lt., A.U.S. 

Minkel, R. M., Newton (APO New York, 

N. Y.) Lt. Col., A.U.S. 

Ritchey, S. J., Newton Lt. Col., A.U.S. 

Jefferson County 

Castell, J. W., Fairfield (APO 9907, New York, 

N. Y.) Capt., A.U.S, 

Frey, Harry, Fairfield (Norfolk, Va.) Lt. Comdr., U.S.N.R. 

Gittler, Ludwig, Fairfield Lt. Col.. A.U.S. 

Graber, H. E., Fairfield (Camp Cooke, Cal.) Major, A.U.S. 

Taylor, I. C., Fairfield (Washington, D. C.) 1st Lt., A.U.S. 

Johnson County 

Agnew, J. W., Iowa City (APO 17604, New York 
N. Y.) Capt., A.U.S. 

Albert, S. M„ Iowa City (APO 9622, New York, 

N. Y.) 1st Lt., A.U.S. 

Allen, J. H., Iowa City (Scott Field, 111.) Major, A.U.S. 

Anderson, E. N., Iowa City (APO 647, New York, 

N. Y.) Major, A.U.S. 

Boyd, E. J., Iowa City (APO 140, New York, N. Y.) .Capt., A.U.S. 

Brinkhous, K. M., Iowa City (APO 4672, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Bunge, R. G., Iowa City (Biloxi, Miss.) 1st Lt., A.U.S. 

Callahan, G. D., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Cobum, F. E., Iowa City (Toronto, Canada) Capt., R.C.A. 

Cooper, W. K., Iowa City (Mitchell Field, N. Y.) . . . .Capt., A.U.S. 

Crowell, E. A., Iowa City (Ft. Geo. Wright. Wash.) .Capt., A.U.S. 

Diddle, A. W., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Dorner, R. A., Iowa City (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Elmquist, H. S., Iowa City (San Diego, Cal.).Lt. Comdr., U.S.N.R. 

Emmons, M. B., Iowa City (Abilene, Texas) Capt., A.U.S. 

Flax, Ellis, Iowa City (APO 6833, New York, N. Y.) 1st Lt., A.U.S. 

Flynn, J. E., Iowa City (Hot Springs, Ark.) Major, A.U.S. 

Fourt, A. S., Iowa City (APO 34, New York, 

N. Y.) Lt. Col., A.U.S. 

Francis, N. L„ Iowa City (Annapolis, Md.)....Lt, (jg), U.S.N.R. 

Galinsky, L. J., Oakdale ((lamp Crowder, Mo.) Capt., A.U.S. 

Garlinghouse, R. O., Iowa City (Ft. Riley, Kan.) . .Lt. Col., A.U.S. 

Hardin, R. C., Iowa City (APO 608, New York, 

N. Y.) Major, A.U.S. 

Hartung, Walter, Iowa City (Camp Carson, Colo.) . .Capt., A.U.S. 

Hessin, A. L., Iowa City (APO 462, New York, 

N. Y.) Major, A.U.S. 

Irwin. R. L., Iowa City (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

January, L. E„ Iowa City (Pyote, Texas) Major, A.U.S. 

Kanealy, J. F., Iowa City (APO 928, San Francisco, 

Cal.) 1st Lt-, A.U.S. 

Keislar, H. D., Iowa City (Washington, D. C.) 1st Lt., A.U.S. 

Lage, R. H., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. U.S.N.R. 

Laubscher, J. H., Iowa City (Ft. Benning, Ga.) . . . .1st Lt., A.U.S. 

Longwell, F. H., Iowa City (Daytona, Fla.) Major, A.U.S. 

Moreland. F. B., Iowa City (Maxwell Field, Ala.) .. 1st Lt,, A.U.S. 

Nagyfy, S. F., Iowa City (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Newman, R. W., Iowa City (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Parkin, G. L., Iowa City (Mountain Home, Idaho) 1st Lt., A.U.S. 

Paulus. E. W., Iowa City (APO 34, New York, 

N. Y.) Lt. Col., A.U.S. 

Petersen, V. W., Iowa City (APO 689, New York, 

N. Y.) Col., A.U.S. 

Sells, R. L., Jr., Iowa City (Palmdale, Cal.) Capt., A.U.S. 

Smith, H. F„ Iowa City (New York. N. Y.) Lt. Comdr., U.S.N.R. 

Springer, E. W., Iowa City (APO 678, New York, 

N. Y.) Capt., A.U.S. 


Stadler, H. E., Iowa City (Washington, D. C.) .... 1st Lt., A.U.S. 
Staggs. W. A., Iowa City (Camp Robinson, Ark.) . .Major, A.U.S. 

Stephens, R. L., Iowa City (Orlando, Fla.) Capt., A.U.S. 

Stump, R. B., Iowa City (Denver, Colo.) Capt.. A.U.S. 

Titus. E. L., Iowa City (Belmont, Mass.) Col., A.U.S. 

Trapasso, T. J., Iowa City (APO 520, New York, 

Ivj. Y.) Capt. A.U.S. 

Trusseli, R. E., Iowa City (APO 5467, San Francisco, 

Cal.) Capt., A.U.S. 

Vest, W. M., Iowa City (Menlo Park, Cal.) Capt., A.U.S. 

Ward, R. H., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Weatherly, H. E., Iowa City (APO 72, San Francisco, 

Cal.) Capt., A.U.S. 

Wollmann, W. W., Iowa City (Staunton, Va.) 1st Lt., A.U.S. 

Ziffren, S. E., Iowa City (Springfield. Mo.) 1st Lt.. A.U.S. 

Junior Members 

Adams, M. P., Iowa City Lt. (jg), U.S.N.R. 

Ahrens, J. H., Iowa City (APO San Francisco, Cal.) ... .A.U.S. 

Ball, A. L., Iowa City (Camp Polk, La.) Major, A.U.S. 

Barrent, M. E., Iowa City (Camp Tyson, Tenn.) . .Capt., A.U.S. 
Black, N. M., Iowa City (McChord Field, Wash.) 1st Lt., A.U.S. 
Blair, J. D„ Iowa City (APO San Francisco. Cal.) .Major, A.U.S. 

Boyd, R. J., Iowa City (Spokane, Wash.) Capt., A.U.S. 

Brintnall, E. S., Iowa City (Colorado Springs, 

Colo.) 1st Lt., A.U.S. 

Burr, S. P., Iowa City (APO San Francisco, Cal.) .1st Lt., A.U.S. 
Carney, R. G., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Connole, J. F., Iowa City (Camp Bowie, Texas) . .1st Lt., A.U.S. 
Couch. 0. A., Iowa City (Camp Van Dom, Miss.) .. 1st Lt.. A.U.S. 
Coulson, P. H., Iowa City (APO New York, N. Y.) . .Capt., A.U.S. 
Decker, C. E., Iowa City (Oklahoma City, Okla.) . .1st Lt., A.U.S. 
Donnelly, B. A., Iowa City (APO San Francisco, 

Cal.) 1st Lt„ A.U.S 

Ehrenhaft, J. L., Iowa City (APO New York, 

N. Y.) 1st Lt., A.U.S. 

Englerth, F. L., Iowa City (APO San Francisco, 

Cal.) Capt., A.U.S. 

Freiberg, M., Iowa City (Jefferson Barracks, Mo.) A.U.S. 

Glassman, A. L., Iowa City (Palm Springs, Cal.) 1st Lt., A.U.S. 

Hamilton, H. E., Iowa City (Chicago, 111.) ....... .1st Lt., A.U.S. 

Harms, G. E., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Hendricks, A. B., Iowa City (Klamath Falls, Ore.) . . .Lt., U.S.N. 
Hovis, Wm., Iowa City (Fleet PO, San Francisco. 

Cal.) Lt. (jg). U.S.N.R. 

Ide, L. W., Iowa City (Port Warren, Wyo.) 1st Lt., A.U.S. 

Jacobs. C. A., Iowa City (APO New York, N. Y.) Major, A.U.S. 
Kaplan, Nathan, Iowa (jity (Carlisle Bar- 
racks, Pa.) 1st Lt., A.U.S. 

Kell, P. G., Iowa City (Sioux City, Iowa) IstLt., A.U.S. 

Kelberg, M. R., Iowa City (Alameda, Cal.) Lt., U.S.N.R. 

Keleher, M. F., Iowa City (Great Lakes, Ill.)..Lt. (jg), U.S.N.R. 

Keohen, G. F., Iowa City (Camp Grant, III.) Capt., A.U.S. 

Kugler, F. E., Iowa City (Fort Warren, Wyo.) Capt., A.U.S. 

Lowry, F. C., Iowa City (Sioux Falls, S. D.) 1st Lt., A.U.S. 

McCann, J. P., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

McQuiston, W. O., Iowa City (APO San Francisco, 

Cal.) Capt., A.U.S. 

Moen, B. H., Iowa City 

Moon, R. E., Iowa City (APO New York, N. Y.) . .1st Lt., A.U.S. 
Odell, Lester, Iowa City (Pensacola, Fla.) . . . .Lt. (jg), U.S.N.R. 
Phillips, R. M., Iowa City (San Francisco, Cal.) . .1st Lt., A.U.S. 
Pulliam, R. L., Iowa City (APO 360, New York, 

N. Y.) Major, A.U.S. 

Randall, C. G., Iowa City 

Randall, R. G., Iowa City (Waterloo, Iowa) .Capt., A.U.S. 

Rosenbusch, M., Iowa City (Fort Leonard Wood, 

Mo.) 1st Lt., A.U.S. 

Russia, L. A., Iowa City (Fort Blanding, Fla.) Capt., A.U.S. 

Saar, J. L., Iowa City (APO New York, N. Y.) .. .Capt., A.U.S. 

Sawtelle, W. W., Iowa City Lt., U.S.N.R. 

Schwidde, J. T., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Shand, J. A., Iowa City (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Shapiro, S. I., Iowa City 

Simpson, P. E.i Iowa City (Camp Grant, 111.) A.U.S. 

Skewis, J. E., Iowa City (Corona, (Jal.) Lt., U.S.N.R. 

Skouge, O. T., Iowa City 

Towle, R. A., Iowa City (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Warren, R. F., Iowa City (Santa Barbara, Cal.) A.U.S. 

Watters, V. G., Iowa City (Fort Leonard Wood, 

Mo.) 1st Lt., A.U.S. 

Wicks, W. J., Iowa City (Camp Crowder, Mo.) Capt., A.U.S. 

Williams, L. A., Iowa City (Treasure Island, Cal.) .1st Lt., A.U.S. 

Willumsen, H. C., Iowa City (Denver, Colo.) Capt., A.U.S. 

Wolkin, J., Iowa City (San Antonio, Texas) Capt., A.U.S. 

Yetter, W. L., Iowa City (APO New York, N. Y.) .. Capt., A.U.S. 

Zahrt, N. E., Iowa City (Keesler Field, Miss.) Capt., A.U.S. 

Zimmerman, H. A., Iowa City (Santa Ana, Cal.) . . 1st Lt.. A.U.S. 
Keokuk County 

Bjork, Floyd, Keota (APO 254, New York, N. Y.) ., Capt., A.U.S. 

Doyle, J. L., Sigourney (Camp Barkeley, Texas) A.U.S. 

Engelmann, A. T., What Cheer (Camp Polk, La.) .. Capt., A.U.S. 

Graham, J. A.. Gibson (Needles, Cal.) 1st Lt., A.U.S. 

Montgomery, G. E., Keota (Antioch, Cal.) Capt., A.U.S. 

Wiley, Dudley, Hedrick (Mason City, Wash.) 

Kossuth County 

Clapsaddle, D. W., Burt (Denver, Colo.) Capt., A.U.S. 

Corbin, R. L., Luverne (Des Moines, Iowa) Capt., A.U.S. 


152 


joruxAi. OF Iowa State Medical Society 


April, 1945 


Kenefick, J. N., Algona (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Williams, R. L., Dakota (Iowa City. Iowa) . ,Lt. Comdr., U.S.N.R. 

Lee County 

Ashline, G. H., Keokuk (APO 253, New York, N. Y.) Capt., A.U.S. 

Cleary, H. G., Fort Madison (Ft. Banning, (ja.) 

Capt., A.U.S. 

Cooper, R. E., Keokuk (APO 565, San Francisco, Cal.) Capt. A.U.S. 

Johnstone, A. A., Keokuk (APO 942, Seattle, Wash.) .Col., A.U.S 

McKee, T. L., Keokuk (Miami Beach, Fla.) Major, A.U.S. 

Puraphrey, L. C., Keokuk (Ft. Leonard Wood, Mo.). Major, A.U.S. 

Rankin. J. R., Keokuk (Memphis, Tenn.) Lt., U.S.N.R. 

Richmond. A. C., Fort Madison (Treasure Island, 

Cal.) Lt. Comdr., U.S.N.R. 

Stefley, F. L., Keokuk (Fort Snelling, Minn.) 

Van Werden, B. D., Keokuk (APO 4777, New York, 

N. Y.) Capt., A.U.S. 

Younan, Thomas, Ft. Madison (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Linn County 

Andre, G. R., Lisbon (APO 90, New York, N. Y.) . .Lt. Col., A.U.S. 

Berney, P. W., Cedar Rapids (APO 207, New York, N. 

Y.) Capt., A.U.S. 

Block, W. M., Cedar Rapids (APO 926, San Francisco, 

Cal.) Capt., A.U.S. 

Chapman, R. M., Cedar Rapids (Chicago. 111.) Capt., A.U.S. 

Coughlan, V. H., Coggon (Fort Snelling, Minn.) A.U.S. 

Counter, W. O., Springville (APO 464, New York, 

N. Y.) Major, A.U.S. 

Downing, J. S., Cedar Rapids (APO 565, SaH Francisco, 

Cal.) Lt. Col., A.U.S. 

Dunn. F. C., Cedar Rapids (Winfield, Kan.) Major, A.U.S. 

Gearhart, Merriam, Springville (APO 204, New York, 

N. Y.) Major, A.U.S. 

Gerstman, Herbert, Marion (APO 862, New York, 

N. Y.) Capt., A.U.S. 

Halpin, L. J., Cedar Rapids (APO 957, San Francisco, 

Cal Major, A.U.S. 

Hecker, J. T., Cedar Rapids (Camp Bowie, Texas) .. Capt., A.U.S. 

Jirsa, H. O., Cedar Rapids (APO 871, New York, 

N. Y.) Lt. Col., A.U.S. 

Keith, J. J., Marion (Menlo Park, Cal.) Major. A.U.S. 

Kieck, E. G., Cedar Rapids (San Diego, Cal.) .Lt. Comdr., U.S.N.R. 

Kruckenberg, W. G., Mount Vernon (Fleet PO, San 

Francisco, Cal.) Lt., U.S.N.R. 

Leedham, C. L., Springville (Camp Campbell, Ky.) ... Col., A.U.S. 

Locher, R. C., Cedar Rapids (APO 18085, New York, 

N. Y.) Major, A.U.S. 

Locher, R. C., Cedar Rapids (Camp Gruber, Okla.) .Major, A.U.S. 

tMacDougal, R. F., Cedar Rapids (APO 9057, New York, 

N. Y.) Capt., A.U.S. 

McConkie, E. B., Cedar Rapids (Hines, 111.) Major, A.U.S. 

McQuiston, J. S., Cedar Rapids (Fort Warren, 

Wyo.) Lt. Col., A.U.S. 

Meffert, C. B., Cedar Rapids (APO 403, New York, 

N. Y.) Lt. Col.. A.U.S. 

Murray, E. S., Cedar Rapids (APO 787, New York. 

N. Y.) Lt. Col., A.U.S. 

Netolicky, R. Y., Cedar Rapids (Hawthorne, 

Nev.) Lt. Comdr.. U.S.N.R. 

Noble, W. C., Cedar Rapids (Camp San Luis Obispo, 

Cal.) 1st Lt., A.U.S. 

Noe, C. A., Cedar Rapids (Hot Springs, Ark.) . . . .Major, A.U.S. 

Parke, John, Cedar Rapids Major, A.U.S. 

Proctor, R. D., Cedar Rapids (Fleet PO, San Fran- 
cisco, Cal.) Comdr., U.S.N.R. 

Redmond, J. J., Cedar Rapids (APO 813, New York, 

N. Y.) Major. A.U.S. 

Rieniets, J. H., Cedar Rapids, (Charleston, S. 

Car.) Lt. Comdr., U.S.N.R. 

Sedlacek, L. B., Cedar Rapids (APO 244, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Smrha, J. A., Cedar Rapids (Topeka, Kan.) Capt., A.U.S. 

Stansbury, J. R., Cedar Rapids (Fort Lewis, 

Wash.) Capt., A.U.S. 

Stark, C. H., Cedar Rapids (Denver, Colo.) Capt., A.U.S. 

Sulek, A. E., Cedar Rapids (APO 244, San Fran- 
cisco, Cal.) Major, A.U.S. 

Woodhouse, K. W., Cedar Rapids (APO 519, New York, 

N. Y.) Lt. Col., A.U.S. 

Wray, R. M., Cedar Rapids (APO 958, San Francisco, 

Cal.) Major, A.U.S. 

Yavorsky, W. D., Cedar Rapids (Jacksonville, Fla.) 

Lt. Comdr.. U.S.N. 

Louisa County 

DeYarman, K. T., Morning Sun (San Antonio, 

Texas) Capt., A.U.S. 

Tandy, R. W., Morning Sun (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Lucas County 

Lister, K. E., Chariton (Fort Snelling, Minn.) A.U.S. 

Lyon County 

Cook, S. H., Rock Rapids (Lordsburg, N. Mex.) . . . .Major, A.U.S. 

{Corcoran, T. E., Rock Rapids (Am. P.O.W. 3040, Oflag 64, 
Germany) Capt., A.U.S. 

Moriarty, J. F., Rock Rapids. (APO 464, New York, 

N. Y.) Capt., A.U.S. 

Dladison County 

Boden, H. N., Truro (Fresno, Call 

Chesnut, P. F., Winterset (Camp Gruber, Okla.) ... .Capt., A.U.S. 

Veltman, J. F., Winterset (APO 957, San Francisco, 

Cal.) Capt., A.U.S. 


Wicks, R. L., Winterset (APO 204, New York, N. Y.) 

Lt. Col., A.U.S. 

Mahaska County 

Bennett, G. W., Oskaloosa (APO 9641, San Francisco, 

Call Major. A.U.S. 

Bos. H. C., Oskaloosa (APO 758, New York, 

N. Y.) Major, A.U.S. 

Campbell, W. V., Oskaloosa (Fleet PO, San Francisco. 

Cal.) Lt. Comdr., U.S.N.R. 

Clark, G. H.. Oskaloosa (Mare Island, Cal.) . .Lt. Comdr., U.S.N.R. 

Gillett, R. M., Oskaloosa (Fleet PO, San Francisco, 

Cal.) Capt., U.S.N. 

Greenlee, M. R., Oskaloosa (Port Hueneme, 

Cal.) Lt. Comdr., U. S.N.R. 

Hibbs, R. E., Oskaloosa Capt., A.U.S. 

Keohen, G. P., Oskaloosa (Washington, D. C.) .... Major, A.U.S. 

Lemon, K. M., Oskaloosa (APO 637, New York, 

N. Y.) Capt., A.U.S. 

Reiley, R. E., Oskaloosa (APO 502, San Francisco, 

Cal.) Major, A.U.S. 

Shurts, J. J., Oskaloosa (Port Mason, Cal.) Capt., A.U.S. 

Zager, L. L., Oskaloosa (APO 436, New York, 

N. Y.) Capt., A.U.S. 

Marion County 

Elliott, V. J., Knoxville (APO 558, New York, 

N. Y.) Major, A.U.S. 

Mater, D. A., Knoxville (Lincoln, Neb.) Major, A.U.S. 

Ralston, F. P., Knoxville (Indio, Cal.) Capt., A.U.S. 

Schiek. C. M., Knoxville Lt. Comdr., U.S.N.R. 

Schroeder, M. C., Pella (Camp Livingston, La.) Capt., A.U.S. 

Williams, D. B., Knoxville Capt., A.U.S. 

Marshall County 

Carpenter, R. C., Marshalltown (APO 678 New York, 

N. Y.) Capt., A.U.S. 

Marble, E. J., Marshalltown (Fleet PO, Can Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Marble, W. P., Marshalltown (Colorado Springs, 

Colo.) Major, A.U.S. 

Meyer, M. G., Marshalltown (APO 513, New York, 

N. Y.) Major, A.U.S. 

Noonan, J. J., Marshalltown (Fort Jackson, 

S. Car.) Lt. Col., A.U.S. 

Phelps, R. E., State Center (APO 7, San Francisco. 

Cal.) Capt., A.U.S. 

Sinning, J. E., Melbourne (Rochester, Minn.) Capt., A.U.S. 

Smith, E. M., State Center (APO 520, New York, 

N. Y.) Lt. Col., A.U.S. 

Stegman, J. J., Marshalltown (AP'^ 520, New York, 

N. Y.) Major, A.U.S. 

Wells, R. C„ Marshalltown (Gowen Field, Idaho) .Capt., A.U.S. 

Wolfe, O. D., Marshalltown (APO 937, Seattle 
Wash.) Capt., A.U.S. 

Wolfe, R. M., Marshalltown (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Mills County 

DeYoung, W. A., Glenwood (APO 228, New York, 

N. Y.) Capt., A.U.S. 

Kuitert, J. H., Glenwood (St. Cloud, Minn.) Major, A.U.S. 

Magaret, E. C., Glenwood (APO 973, Minneapolis, 

Minn.) Capt., A.U.S. 

Shonka, T1 E., Malvern (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Mitchell County 

Culbertson, R. A., St. Ansgar (APO 331, San 
Francisco, Cal.) Lt. Col., A.U.S. 

Moore, E. E., Osage (APO 591, New York, N. Y.) .Major, A.U.S. 

Owen, W. E., Osage (Fleet PO, San Francisco, Cal.) 

.' Lt. (jg),U.S.N.R. 

Walker, T. G., Riceville (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

Monona County 

Aimer, L. E., Moorhead (Port Knox, Ky.) Capt., A.U.S. 

Anderson, S. N., Onawa (Great Lakes, 111.) Lt., U.S.N.R. 

Ganzhorn, H. L., Mapleton (APO 72, San Francisco, 

Cal.) Capt., A.U.S. 

Gaukel, L. A., Onawa (Fort Riley, Kan.) Capt., A.U.S. 

fHarlan, M. E., Onawa (Fleet PO, San Francisco, 

Cal.) Lt. (jg), U.S.N.R. 

Stauch, M. O., Whiting (Fort Lewis, Wash.) Major, A.U.S. 

Wainwright, M. T., Mapleton (Hines, 111.) Capt., A.U.S. 

Wolpert, P. L., Onawa (Camp Atterbury, Ind.) .... Capt., A.U.S. 

Monroe County 

Gilliland, C. H., Albia (Fleet PO, San Francisco, Cal.) .Lt., U.S.N. 

Heimann, V. R., Albia (Camp Maxey, Texas) Capt., A.U.S. 

Richter, H. J., Albia (Waco, Texas) Major, A.U.S. 

Smith, R. A., Albia (New Cumberland, Pa.) Capt.. A.U.S. 

Montftoniery County 

Bastron, H. C., Red Oak (APO 951, San Francisco, 

Cal.) Major, A.U.S. 

Hansen, F. A., Red Oak (Clarksville, Ark.) Lt., U.S.N.R. 

Nelson, C. C., Red Oak (Fleet PO, San Francisco, 

C^l.) Lt., U.S.N.R. 

Panzer, E. J. C., Stanton (Fleet PO, San Francisco, 

Cal.) Lt. (jg), U.S.N.R. 

Rost, G. S., Red Oak (Halstead, Kan.) Capt., A.U.S. 

Sorensen, E. M., Red Oak (Jefferson Barracks, 

Mo.) Capt., A.U.S. 

Muscatine County 

Ady, A. E., West Liberty (Pensacola, Fla.) Comdr., U.S.N.R. 

'Asthalter, R. W., Muscatine (Fort Meade, Md.) ... 1st Lt., A.U.S. 

Carlson, E. H., Muscatine (Camp Ellis, 111.) Capt., A.U.S. 

Goad, R. R., Muscatine (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


153 


Kimball, J. E., Jr., West Liberty (Sioux City, Iowa) .Major, A.U.S. 
Lindley, E. L., Muscatine (APO 6, San Francisco, 


Cal.) Capt., A.U.S. 

Muhs, E. 0., Muscatine (APO 578, New York, 

N. Y. ) Major, A.U.S. 

Norem. Walter, Muscatine (APO, Miami, Fla.) Capt., A.U.S. 

Robertson, T. A., West Liberty (APO 119, New York, 

N. Y.) Capt., A.U.S. 

Sywassink, G. A., Muscatine (APO 488-“Y” 

Forces, New York, N. Y.) Lt. Col., A.U.S. 

Whitmer, L. H., Wilton Junction (Fort Sill, 

Okla.) Lt. Col., A.U.S. 

O’Brien County 

Getty, E. B., Primghar (APO 739, New York, 

N. Y.) Capt., A.U.S. 

Hayne, W. W.. Paullina (APO 638, New York, 

N. Y.) Capt., A.U.S. 

Moen, S. T., Hartley (APO 689, New York, 

N. Y.) Lt. Col., A.U.S. 

Myers. K. W., Sheldon (APO 559. New York, 

N. Y.) Capt., A.U.S. 

Osceola County 

Kuntz, G. S., Sibley (APO 34, New York. N. Y.) Capt., A.U.S. 


Pagrc County 

Barnes, C. A. Shenandoah (APO New York, N. Y.) . .Capt., A.U.S. 

Bauer, Frank, Shenandoah (APO New York, N. Y.) A.U.S. 

Blackman. Nathan, Clarinda (Ft. Leavenworth, 

Kan.) Capt., A.U.S. 

Bossingham, E. N.. Clarinda (Fort Ord, Cal.) Major, A.U.S. 

Brush, Frederick, Shenandoah (APO New York, N. Y.)... A.U.S. 
Bunch, H. McK., Shenandoah (San Diego, 

Cal.) Lt. Comdr., U.S.N.R 

Burdick, F. D., Shenandoah (Denver, Colo.) Capt., A.U.S. 

Burnett, F. K., Clarinda (APO 11336, New York, 

N. Y.) Major, A.U.S. 

Rausch, G. R., Clarinda (Sioux City, Iowa) Capt.; A.U.S. 

Savage. L. W.. Shenandoah (Fort Meade, Md.) .... 1st Lt., A.U.S. 
Schwiddie, Tilford. Shenandoah (APO New York, N. Y.).. A.U.S. 


Palo Alto County 

Davey, W. P.. Emraetsburg (Fleet PO, San 

Francisco, Cal.) Lt., U.S.N.R. 

Plymouth County 

Bowers. C. V., LeMars (APO New York, N. Y.) . .1st Lt., A.U.S. 

Fisch, R. J., LeMars (Denver, Colo.) Capt., A.U.S. 

Foss, R. H„ Remsen (Homestead, Fla.) Capt., A.U.S. 

Wolfson. .Harold, Kingsley (Fort Lewis, Wash.) ... .Capt., A.U.S. 


Pocahontas County 

Blair, F. L., Jr., Fonda (San Antonio, Texas) Lt., U.S.N.R. 

Herrick, T. G., Gilmore City (APO 9876, New York, 

N. Y.) Capt., A.U.S. 

Larson, J. B., Laurens (APO 720, San Francisco, 

Cal.) Capt., A.U.S. 

Leserman, L. K.. Rolfe (APO 502, 5an Francisco, 

Cal.) Capt., A.U.S. 

Patterson, A. W., Fonda (Des Moines, Iowa) Capt., A.U.S. 

Polk County 

Abbott, W. D., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Anderson, N. B., Des Moines (APO 667, New York, 

N. Y.) Lt. Col., A.U.S 

Angell, C. A., Des Moines (Ft. Bragg, N. Car.) Capt., A.U.S. 

Anspach, R. S., Mitchellville (APO 628, New York, 

N. Y.) Lt. Col., A.U.S. 

Barnes, B. C., Des Moines (APO 4294, San Fran- 
cisco, Cal.) Major, A.U.S. 

Bates, M. T., Des Moines (Corona, Cal.) ... .Lt. Comdr., U.S.N.R. 

Bender, H. R., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

Bond, T. A., Des Moines (Shoemaker, Cal.) Lt., U.S.N.R. 

Bone, H. C., Des Moines (Arlington, Cal.) Major, A.U.S. 

Brown, A. W., Des Moines (APO 6934, New York, 

N. Y.) Capt., A.U.S. 

Bruner, J. M., Des Moines (Camp Barkeley, Texas) . .Major, A.U.S. 

Bruns, P. D., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt., A.U.S. 

+Burgeson, F. M., Des Moines Capt., A.U.S. 

Caldwell, J. W., Des Moines, (Patricia Bay, 

British Columbia, Canada) Flight Lt., R.C.A.F. 

Chambers, J. W., Des Moines (APO 667, New York, 

N. Y.) Capt., A.U.S. 

Chase, W. B., Jr., Des Moines (Fleet PO, San Francisco, 

Cal.) : Lt., U.S.N.R. 

Clark, G. E., Jr., Des Moines (APO 620, New York, 

N. Y.) Capt., A.U.S. 

Connell, J. R., Des Moines (APO 607, New York, 

N. Y.) ; Major, A.U.S. 

Corn, H. H., Des Moines (Camp Beale, Cal.) Capt., A.U.S. 

Coughlan, D. W., Des Moines (APO 689, New York, 

N. Y.) Capt., A.U.S. 

Crowley, D. F., Jr., Des Moines (Presque Isle, Me.) . .Capt., A.U.S. 

Crowley, F. A., Des Moines (APO 783, New York, 

N. Y.) Capt., A.U.S. 

DeCicco, Ralph, Des Moines (APO 952, San Francisco, 

Cal.) Capt., A.U.S. 

Decker. H. G., Des Moines (Long Beach, 

Cal.) Lt. Comdr., U.S.N.R. 

Downing, A. H„ Des Moines (Ft. Snelling, Minn.) .1st Lt., A.U.S. 

Dusbkin, M. A., Des Moines (APO 689, New York, 

N. Y.) Lt. Col., A.U.S. 

Elliott, O. A., Des Moines (Pecos, Texas) Capt., A.U.S. 

Ellis, H. G., Des Moines (APO 710, San Francisco, 

Cal.) Capt.. A.U.S. 


Ervin, L. J„ Des Moines (Victoria, Texas) Lt. Qol., A.U.S. 

Fleck, W. L., Des Moines (Ft. Howard, Md.) Lt. Col., A.U.S. 

Fried. David, Des Moines (Carlisle Barracks, 

Penn. ) 1st Lt., A.U.S. 

Fracasse. John, Des Moines 1st Lt., A.U.S. 

George, E. M., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Gerchek, E. W., Des Moines 

Gibson, D. N., Des Moines (APO 322, Unit I, San 
Francisco, Cal.) Major, A.U.S. 

Glomset, D. A., Des Moines (APO 9826 New York, 

N. Y.) Capt., A.U.S. 

Goldberg, Louie, Des Moines (APO 926, San Francisco, 

Cal.) Capt., A.U.S. 

Gordon, A. M., Des Moines (APO 600, New York, 

N. Y.) Capt., A.U.S. 

Graeber, F. O.. Des Moines (Fleet PO. San Francisco, 

Cal.) Lt., U.S.N.R. 

Greek, L. M., Des Moines (APO 612, New York, 

N. Y.) Capt., A.U.S. 

Gurau, H. H., Des Moines (Malden, Mo.) Capt., A.U.S. 

Haines, D. J., Des Moines (APO 463, San Francisco, 

Cal.) Capt., A.U.S. 

Harris, D. D., Des Moines (Gulfport, Miss.) . .Lt. Comdr., U.S.N.R. 

Harris, H. L., Des Moines (Salina. Kan.) 1st Lt., A.U.S. 

Hess, John, Jr., Des Moines 1st Lt., A.U.S. 

James, A. D., Des Moines (Fort Eustis, Va.) .. .Comdr., U.S.N.R. 

Johnston, C. H., Des Moines (Randolph Field, 

Texas) Lt. Col., A.U.S. 

Kast, D. H., Des Moines (Fort Stevens, Ore.) Capt., A.U.S. 

Kelley, E. J., Des Moines (Columbus, Ohio) . .Lt. Comdr., U.S.N.R. 

Kirch, W. A. W., Des Moines (Astoria, Ore.) .Lt. Comdr., U.S.N.R. 

Klocksiem, H. L., Des Moines (APO New York, 

N. Y.) Capt., A.U.S. 

Kottke, E. E., Des Moines (Temple, Texas) Capt., A.U.S. 

Landis, S. N., Des Moines (West P^m Beach, 

Fla.) 1st Lt., A.U.S. 

La Tona, Salvatore, Des Moines 1st Lt., A.U.S. 

Lederman, James, Des Moines 1st Lt., R.C.A. 

Lehman, E. W., Des Moines (APO 711, 

San Francisco. Cal.) Major, A.U.S. 

Losh, C. W., Jr., Des Moines (APO 209, New York, 

N. Y.) .Capt., A.U.S. 

Lovejoy, E. P., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Maloney, P. J., Des Moines (Fort Lewis, Wash.) . . .1st Lt., A.U.S. 

Marquis, G. S., Des Moines (Brooklyn, N. Y.) .Lt. Comdr., U.S.N.R. 

Martin, L. E., Des Moines (Helena, Ark.) 1st Lt., A.U.S. 

Matheson, J. H., Des Moines (San Leandro, 

Cal.) Lt. Comdr., U.S.N.R. 

Mauritz, E. L., Des Moines (APO 763, New York, 

N. Y.) Capt., A.U.S. 

McCoy, H. J., Des Moines (Iowa City, Iowa) .. .Comdr., U.S.N.R. 

McDonald, D. J., Des Moines (APO 339, New York, 

N. Y.) Major, A.U.S. 

McNamee, J. H., Des Moines (Fleet PO, San Fran- 
cisco; Cal.) Lt. Comdr., U.S.N.R. 

Mencher, E. W., Des Moines 1st Lt., A.U.S. 

Merkel, B. M„ Des Moines (APO 620, New York, 

N. Y.) Major, A.U.S. 

Montgomery, S. A., Des Moines (Carlisle Barracks, 

Pa.) Capt., A.U.S. 

Morden, R. P.. Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Mumma, C. S., Des Moines (Los Angeles, Cal.) ... .Major, A.U.S. 

Murphy, J. H., Des Moines (Fleet PO, San Fran- 
cisco, Cal.) Lt., U.S.N.R. 

Nelson, A. L., Des Moines (Camp Livingston, La.) Major. A.U.S. 

Noun, L. J., Des Moines (Camp Peary, Va.) Lt., U.S.N.R. 

Noun, M. H., Des Moines (APO 228, New York, 

N. Y.) Major. A.U.S 

Nourse, M. H., Des Moines (Fleet PO, New York, 

N. Y.) Lt., U.S.N. 

Patton, B. W., Des Moines (Camp Robinson, 

Ark.) 1st Lt., A.U.S. 

Pearlman, L. R., Des Moines (Battle Creek, Mich.) . .Major, A.U.S. 

Peisen, C. J., Des Moines (APO 165, New York, 

N. Y.) Capt, A.U.S. 

Penn, E. C., West Des Moines (APO 660, New York, 

N. Y.) Capt., A.U.S. 

Pfeiffer, E. P., Des Moines (APO 501, San Fran- 
cisco, Cal.) Capt.. A.U.S. 

Phillips, A. B„ Des Moines (Corona, Cal.) Lt., U.S.N.R. 

Porter, R. J., Des Moines (APO 635, New York, 

N. Y.) i Capt., A.U.S. 

Powell, L. D., Des Moines (Oceanside, Cal.) Capt., U.S.N.R. 

Pratt, E. B„ Des Moines (APO New York, N. Y.) . .Major, A.U.S. 

Priestley, J. B., Des Moines (APO 11377, New York, 

N. Y.) Lt. Col., A.U.S. 

Purdy. W. O., Des Moines (APO 6935, New York, 

N. Y.) Capt., A.U.S. 

Riegelman, R. H., Des Moines (APO 569, New York, 

N. Y.) Major, A.U.S. 

Robinson, V. C., Des Moines (Gulfport, Miss.) Major, A.U.S. 

Rotkow, M. J., Des Moines (Ft. Benj. Harrison, 

Ind.) Capt., A.U.S. 

Schaeferle, M. J., Des Moines (Carlisle Barracks, 

Penn.) 1st Lt. A.U.S. 

Schlaser. V. L., Des Moines (Hutchinson, Kan.) Lt, U.S.N. 

Shepherd, L. K., Des Moines (APO New York, 

N. Y.) Major, A.U.S. 

Shiffler. H. K., Des Moines (APO 230, New York, 

N. Y.) Capt., A.U.S. 


15 ^ 


Joi’KXAL OF [owA State Medical Society 


April, 1945 


Singer, P. L.. Des Moines (Camp Grant, 111.) . . . . 1st Lt., A.U.S. 

Skultety, J. A., Des Moines (New Orleans, La.) 

P. A. Surg., U.S.P.H.S. 

Smead. H. H., Des Moines (AI’O 595, New York, 

N. Y.) Capt.. A.U.S. 

Smith, H. J., Des Moines (Chicago, 111.) Lt., U.S.N.R. 

Smith. R. T., Des Moines (APO 713, Unit I, San Francisco, 

Cal.) Capt., A.U.S. 

•Snodgrass, R. W., Des Moines (APO 9528, New York, 

N. Y.) Capt., A.U.S 

Snyder, G. E., Grimes (APO 264, San Francisco, 

Cal.) Major. A.U.S. 

Sohm, H. A., Des Moines (Great Lakes, 111.) .Lt. Comdr., U.S.N.R. 

Sorensen, R. M., Des Moines (Topeka, Kan. ).. Major, U.S.P.H.S. 

Springer, F. A., Des Moines (Treasure Island. 

Cal.) Lt. Comdr., U.S.N.R. 

Stearns, A. B., Des Moines (Denver, Colo.) Major, A.U.S. 

Stickler, Robert, Des Moines (APO New York, 

N. Y.) Major, A.U.S. 

Stitt, P. L„ Des Moines (Seattle, Wash.) Lt. (jg) , U.S.N.R. 

Throckmorton, J. F., Des Moines (APO 339, New York, 

N. Y.) Major, A.U.S. 

Toubes, A. A., Des Moines (APO 635, New York, 

N. Y.) Capt., A.U.S. 

Turner, H. V., Des Moines (Camp Fannin, Texas) . . .Capt., A.U.S. 

Updegraflf, Thomas. Des Moines (Spokane, Wash.) . 1st Lt., A.U.S. 

Van Hale, L. A., Des Moines (Clinton, Iowa) Major, A.U.S. 

Vaubel, E. K., Des Moines (Washington, D. C.) ... .Capt., A.U.S. 

Wagner, E. G„ Des Moines (Washington, D. C.) . .1st Lt., A.U.S. 

Willett, W. M., Des Moines (APO 507, New York, 

N. Y.) Capt., A.U.S. 

Wirtz, D. C., Des Moines (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Zarchy, A. C.. Des Moines (Camp Cooke. Cal.) ... .Capt., A.U.S. 

Pottasvattamie County 

JBeaumont, F. H., Council Bluffs (APO 34, New York, 

N. Y.) Major, A.U.S. 

Collins, R. M., Council Bluffs (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

Dean, A. M., Council Bluffs (Pensacola, Fla.) .. .Comdr., U.S.N.R. 

Edwards, C. V., Council Bluffs (Pensacola, Fla.) 

Lt. Comdr., U.S.N.R. 

Floersch, E. B., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Lt. Comdr., U.S.N.R. 

Hennessy, J. D., Council Bluffs (Shawnee, 

Okla.) Lt. Comdr, U.S.N.R. 

Jensen, A. L., Council Bluffs (Temple, Texas) . . . .Lt. Col., A.U.S. 

Klok, G. J., Council Bluffs (Fleet PO, San Diego, 

Cal.) Lt., U.S.N.R. 

Kurth, C. J., Council Bluffs (Camp Crowder, Mo.) . .Capt., A.U.S. 

Limbert, E. M., Council Bluffs (APO 403, New York, 

N. Y.) Major, A.U.S. 

Maiden, S. D„ Council Bluffs (Camp Hood, Texas). .Major, A.U.S. 

Martin, L. R., Council Bluffs (San Francisco, Cal.) . .Capt., A.U.S. 

Mathiasen, H. W., Neola (Alexandria. La.) Capt., A.U.S. 

Moskovitz, J. M., Council Bluffs (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Rosenfeld. R. T., Council Bluffs (Staten Island, 

N. Y.) Capt., A.U.S. 

Standeyen, W., Oakland (Colorado Springs, Colo.) .. Capt., A.U.S. 

Sternhill, Isaac, Council Bluffs (Camp Crowder, 

Mo.) Capt., A.U.S. 

Tinley, R. E., Council Bluffs (APO 600, New York, 

N. Y.) Major, A.U.S. 

Treynor, J. V., Council Bluffs (Fleet PO, San Fran- 
cisco, Cal.) Comdr., U.S.N.R. 

West, A. G., Council Bluffs (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Wieseler, R. J., Avoca (McChord Field, Wash.) A.U.S. 

Wurl, O. A., Council Bluffs (APO 887, New York, 

N. Y.) Lt. Col., A.U.S. 

Powe.sliiek County 

Brobyn, T. E.. Grinnell (APO 18593, New York, 

N. Y.) Major, A.U.S. 

Hickerson, L. C., Brooklyn (APO 559, New York, 

N. Y.) Capt., A.U.S. 

Korfmacher, E. S., Grinnell (APO 92, San Francisco, 

Cal.) Capt., A.U.S. 

Niemann, T. V., Brooklyn (APO 43, San Francisco, 

Cal.) Capt., A.U.S. 

Parish, J. R., Grinnell (Fleet PO, San Francisco, 

Cal. ) Lt. Comdr. .U.S.N.R. 

Somers, P. E., Grinnell (St. Louis, Mo.) 1st Lt., A.U.S. 

Ringgold County 

Seaman, C. L., Mount Ayr (Fort Smith, Ark.) ... .Major, A.U.S. 

Sac County 

Bassett, G. H., Sac City ( Metairie, La.) Lt. Comdr., U.S.N.R. 

Deters, D. C., Schaller (APO 34, New York, N. Y Capt., A.U.S. 

Evans, W. I., Sac City (APO 9212, New York, 

N. Y.) Capt., A.U.S. 

Klocksiem, R. G., Odebolt (Oceanside, Cal.) Lt,, U.S.N.R. 

Neu, H. N., Sac City (APO 708, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Scott County 

fBaker, R. W., Davenport (APO 511, New York, 

N. Y.) Capt., A.U.S. 

Balzer, W. J., Davenport (APO 569, New York, 

N. Y.) Capt., A.U.S. 

Bishop. J. F., Davenport (Camp Wheeler, Ga.) .... Capt., A.U.S. 

Block, L. A.. Davenport (Cambridge, Ohio) Major, A.U.S. 

Boden. W. C., Davenport (APO 3760, New York, 

N. Y.) Capt., A.U.S. 

Boyer, U. S., Davenport (Rock Island, 111.) Lt. Col., A.U.S. 


Brown, M. J., Davenport (APO 562, New York, 

N. Y.) Major, A.U.S. 

Carey, E. T., Davenport (APO 928, San Francisco, 

Cal.) 1st Lt., A.U.S. 

Christiansen, C. C., Dixon (APO 961, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Coleman, Tom, Davenport (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Cummins, G. M., Jr., Davenport (Fort Custer, 

Mich.) Capt., A.U.S. 

Decker, C. E„ Davenport (APO 321, San Francisco, 

Cal.) Major, A.U.S. 

Evans, H. J., Davenport (Daytona Beach, Fla.) Capt., A.U.S. 

Gibson, P. E., Davenport (Palm Springs, Cal.) Major, A.U.S. 

Goenne, Wm., Jr., Davenport (APO 91, New York, 

N. Y.) Capt., A.U.S. 

Hurevitz, H. M., Davenport (APO 370, New York, 

N. Y.) Major, A.U.S. 

Hurteau, Everett, Davenport (APO 647, New York, 

N. Y.) Capt., A.U.S. 

Hurteau, W. W., Davenport (Camp Barkeley, 

Texas) Major, A.U.S. 

Kimberly, L. W., Davenport (Hines, 111.) Capt., A.U.S. 

Krakauer, Max, Davenport (APO 655, New York, 

N. Y.) Capt., A.U.S. 

Kuhl, A. B., Jr., Davenport (Ft. Meade, Md.) 1st Lt., A.U.S. 

LaDage, L. H., Davenport (APO 229, New York, 

N. Y.) Major, A.U.S. 

Lorfeld, G. W., Davenport (Columbus, Ohio) Capt., A.U.S. 

McMeans, T. W., Davenport (APO 557, New York, 

N. Y.) Capt., A.U.S. 

Neufeld, R. J., Davenport (APO 665, Unit I, San Francisco, 

Cal.) Capt., A.LT.S. 

Perkins, R. M., Davenport (APO 121B, New York, 

N. Y.) Capt., A.U.S. 

Sheeler, I. H., Davenport (APO 350, New York, 

N. Y.) Capt., A.U.S. 

Shorey, J. R., Davenport (APO 204, New York. 

N. Y.) Capt., A.U.S. 

Smazal, S. F., Davenport (APO 230, New York, 

N. Y.) Capt., A.U.S. 

Sorenson, A. C.. Davenport (Oakland, Cal.) .. .Comdr., U.S.N.R. 

Sunderbruch, J. H., Davenport (APO 322, San Fran- 
cisco, Cal.) Capt., A.U.S. 

Weinberg, H. B., Davenport (APO 72, San Francisco, 

Cal.) Major, A.U.S. 

Zukerman, C. M., Bettendorf (Chicago, 111.) Capt., A.U.S. 

Shelby County 

Bisgard, C. V., Harlan (Farragut, Idaho) .. .Lt. Comdr., U.S.N.R. 

Griffith, W. O., Shelby (APO 9490, New York, 

N. Y.) Capt., A.U.S. 

McGowan, J. P., Harlan (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Sioux County 

Gleysteen, R. R., Alton (Portsmouth, Va.)....Lt. Comdr., U.S.N. 

Grossmann, E. B., Orange City (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Larson, M. O., Hawarden (APO 562, New York, 

N. Y.) Lt. Col., A.U.S. 

Oelrich, A. M., Hull (APO New York, N. Y.) ... ,1st Lt., A.U.S. 

Oelrich, C. D., Sioux Center (Buckley Field, Colo.) .1st Lt., A.U.S. 

Story County 

Conner, J. D., Nevada (APO 708, San Francisco, 

Cal.) Capt., A.U.S. 

Fellows. J. G., Ames (APO 451, New York, N. Y.) . .Major, A.U.S. 

Lekwa. A. H., Story (jity (San Diego, Cal.)..Lt. Comdr., U.S.N.R. 

McFarland, G. E., Jr., Ames (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N.R. 

McFarland, J. E., Ames (Seattle, Wash.) . . . .Lt. Comdr., U.S.N.R. 

Rosebrook, L. E., Ames (APO 433, New York 
N. Y.) Major, A.U.S. 

Sperow, W. B., (Fleet PO, San Francisco, 

Cal.) ...) Lt. Comdr., U.S.N.R. 

Thorburn, O. L., Ames (Clovis, N. Mex.) Major, A.U.S. 

Wall, David, Ames (Ft. Dix, N. J.) 1st LL, A.U.S. 

Tania County 

Bezman, H. S., Traer (APO 9875. New York, N. Y.) Capt., A.U.S. 

Boiler, G. C., Traer (Ft. Riley, Kansas) Capt., A.U.S. 

Dobias, S. G., Chelsea (APO 17928, San Francisco, 

Cal.) Capt., A.U.S. 

Havlik, A. J., Tama (Fleet PO, San Francisco, Cal) . .Lt., U.S.N.R. 

Schaeferle, L. G., Gladbrook (APO New York, 

N. Y.) Capt., A.U.S. 

Standefer. J. M., Tama (Des Moines, Iowa) Lt., U.S.N.R. 

Taylor County 

Hardin. J. F., Bedford (APO 952, San Francisco, 

Cal.) 1st Lt., A.U.S. 

Union County 

Beatty, H. G.. Creston (New Orleans, La.) 1st Lt., A.U.S. 

Paragas, M. R., Creston (APO 442, San Francisco, 

Cal.) Capt., A.U.S. 

Ryan, C. J.. Creston Capt., A.U.S. 

Wapello County 

Brentan, Emanuel, Ottumwa Capt., A.U.S. 

Brody, Sidney, Ottumwa Lt. Col., A.U.S. 

Gilfillan, C. D. N., Eldon (Battle Creek. Mich.) .... Capt., A.U.S, 

Howell, H. P., Ottumwa (Hamilton Field, Cal.). .. .Major, A.U.S. 

Hughes, R. O., Ottumwa (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Moore, G. C., Ottumwa (APO 17508, New York, 

N. Y.) Capt.. A.U.S. 

Nelson. F. L., Jr., Ottumwa (Springfield, Mo.) Capt., A.U.S. 

Prewitt, L. H., Ottumwa (Atlantic City, N. J.) Major, A.U.S. 

Selman, R. J., Ottumwa (El Paso, Texas) Col., A.U.S. 


VoL. XXXV, No. 4 


155 


Journal of Iowa State Medical Society 


Struble. G. C., Ottumwa (Fort Harrison, Ind.) Lt. Col., A.U.S. 

Whitehouse, W. N., Ottumwa (San Diego, 

Qal.) Lt. Comdr., U.S.N.R. 

Warren County 

Fullgrabe, E. A., Indianola (Fleet PO, New York, 

N. Y.) Lt., U.S.N.R. 

HoflEman, G. R., Lacona (Camp San Louis Obispo, 

Cal.) Capt., A.U.S. 

Shaw, E. E., Indianola (APO 834, New Orleans, 

La.) Capt., A.U.S. 

Trueblood, C. A., Indianola (APO 360, New York, 

N. Y.) Capt., A.U.S. 

Washington County 

Boice, C. L., Washington (Fleet PO, San Francisco, 

Cal.) Lt., U.S.N. 

Droz, A. K., Washington (Fleet PO, San Francisco, 

Cal ) Comdr., U.S.N.R. 

Mast, T. ii.’, Washington (Arrowhead Springs, 

Cal ) Lt. Comdr., U.S.N.R. 

Miller, J. R.','Wellman (APO New York, N. Y.) 1st. Lt., A.U.S. 

Stutsman, R. E, Washington (Patuxent River, 

) Lt., U.S.N.R. 

Ware, S. C., kaioiia" (APO 218, New York, N. Y.) . .Capt., A.U.S. 

Wayne County 

Hyatt, C. N., Jr., Humeston (APO 6, San Francisco, 

Cal.) Capt., A.U.S. 

Webster County 

Baker, C. J., Fort Dodge (APO New York, N. Y.) . .Major, A.U.S. 

Burch, E. S., Dayton (Palm Springs, Cal.) Capt., A.U.S. 

Burleson, M. W., Fort Dodge (Pasadena, Cal.) Capt., A.U.S. 

Coughlan, C. H., Fort Dodge (Camp Carson, Colo.) . .Major, A.U.S. 

Dawson, E. B., Fort Dodge (San Diego, xy r, xr 

\ Lt. Comdr., U.S.N.R. 

Glesne, 6. N-. Ft. Dodge (New River, N. C.l.Lt. Comdr., U.S.N.R. 

Joyner, N. M., Fort Dodge (Minneapolis, Minn.) A.U.S. 

Kluever, H. C., Fort Dodge (St. Louis, Mo.) „ o - kt -d 

Lt. Comdr., U.S.N.R. 

Larsen, H. T., Fort Dodge (Pensacola, Fla.) Lt., U.S.N.R. 

Shrader, J. C., Fort Dodge (APO 758, New York, 

N Y.) Lt. Col., A.U.S. 

tThatcher’ O.’ D.! Fort Dodge (APO 634, New York, 

N Y ) Capt., A.U.S. 

Thatcher, W." C.’, Fort Dodge (APO 464, New York, 

Y.) Capt., A.U.S. 

Van Patten," E. M., Ft. Dodge (El Paso, Texas) Capt., A.U.S. 

Winneshiek County 

Fritchen, A. F.. Decorah (Mare Island, Cal.) . .Comdr., U.S.N.R. 

Hospodarsky, L. J., Ridgeway (APO 638, New York, . c 
jq- Y) Dt. Col., A.U.o. 

Howard, W. H., Decorah Capt., A.U.S. 

Larson. L. E., Decorah (Fleet PO, San Francisco. „ „ , , „ 

Svendsen. R. n!, bec'orah (San Diego, Cal.)...Lt. (jg), U.S.N.R. 

Van Besien, G. J., Decorah (Springfield, Mo.) ... .Capt., A.U.S. 

Woodbury County 

Bettler, P. L., Sioux City (APO 236, San Francisco, 

Cal.) Lt. Col., A.U.S. 

Blackstone, M. A., Sioux City (Camp Stoneman, 

Cal.) Capt., A.U.S. 

Boe, Henry, Sioux City (Fort Snelling, Minn.) Capt., A.U.S. 

Burroughs, H. H., Sioux City (Fleet PO, San Fran- „ ^ „ 

cisco. Cal.) Lt., U.S.N.R. 

JCmeyla, P. M., Sioux City (P.O.W., c/o Japanese 

Red Cross, Tokyo, Japan) Capt., A.U.S. 

Cowan, J. A., Sioux City (Oklahoma City, 

Okla.) Major, U.S.P.H.S. 

Crowder, R. E., Sioux City (Kansas City, 
jlo ) Lt. Comdr., U.S.N.R. 

Dimsdale, L. j., Sioux City (Clinton, Iowa) Capt., A.U.S. 

Down, H. I., Sioux City (APO 758, New York, 

Y.) Lt. Col., A.U.S. 

Elso’n, V. .i.’, Danbury (APO 9875, New York, 

j.j_ Y.) Capt., A.U.S. 

Frank. L. J., Sioux City (Fleet PO, San Francisco, 

Cal.) Comdr., U.S.N.R. 

Graham, j.’w., Sioux City (Pensacola, Fla.) Lt. Comdr., U.S.N.R. 

Grossman, M. D., Sioux City (APO 33, San Francisco, 

Cal.) Capt., A.U.S. 

Harris, D M., Sioux City (APO 444, New York, 

N. Y.) Capt., A.U.S. 

HefTernan, C. E., Sioux City (APO 17682, San 

Francisco, Cal.) Capt., A.U.S. 

Hicks, W. K., Sioux City (Spokane, Wash.) Major, A.U.S. 

Honke, E. M., Sioux City (Palm Springs, Cal.) Major, A.U.S. 

Kaplan, Davi4 Sioux City (APO 36, New York, 

N. Y.) Capt., A.U.S. 

Knott. P. D., Sioux City (Camp Crowder, Mo.) Capt., A.U.S. 

Knott, R. C., Sioux City (APO 403, New York, 

N. Y.) Major, A.U.S. 

Krigsten, W. M., Sioux City (Springfield, Mo.) .. .Lt. Col., A.U.S. 

Lande, J. N., Sioux City (APO 63, New York, N. Y.) Major, A.U.S. 

Martin, R. F., Sioux City (APO 403, New York, 

N. Y.) Capt., A.U.S. 

Mattice, L. H., Danbury (APO 713, San Francisco, 

Cal.) 1st Lt., A.U.S. 

McCuistion, H. M., Sioux City (APO 209, New York, 

N. Y.) Capt., A.U.S. 

Mugan, R. C.. Sioux City (Miami Beach, Fla.) Capt., A.U.S. 

Osincup, P. W., Sioux City (APO 520, New York, 

N. Y.) Capt, A.U.S. 

Rarick, I. H., Sioux City (Camp Pinedale, Cal.) .... Capt, A.U.S. 


Reeder, J. E., Jr., Sioux City (APO 209, New York, 


N. Y.) Capt, A.U.S. 

Ryan. M. J., Sioux City (Topeka, Kan.) Major, A.U.S. 

Schwartz, J. W., Sioux City (APO 883, New York, 

N. Y.) Lt. Col., A.U.S. 

Tracy, J. S., Sioux City (APO 669, New York, 

N. Y.) Major, A.U.S. 

Worth County 

Westly, G. S., Manly (APO 927, San Francisco, 

Cal.) Major. A.U.S. 


Wright County 

Aagesen, C. A., Dows (APO 383, New York, N. Y.) 

Capt, A.U.S. 

Bird, R. G., Clarion (Fleet PO, San Francisco, 

Cal.) Lt. Comdr., U.S.N.R. 

Doles, E. A., Clarion (Spokane, Wash.) Capt, A.U.S. 

Gorrell, R. L., Clarion (Denver, Colo.) . . . .P.A. Surg., U.S.P.H.S. 
Leinbach, S. P., Belmond (Farragut Air Base, Idaho) 

Missildine, W, H., Eagle Grove (APO 25, San Francisco, 

Cal.) Capt, A.U.S. 


(•) Reported missing in action, 
(t) Reported deceased in service, 
(t) Reported prisoner of war. 


FEDERAL REGULATION 

(Continued from page 147) 

are available to anyone who applies for such serv- 
ice. Similarly, medical diagnosis is made freely 
available to anyone who applies for services under 
State vocational-rehabilitation programs. The Rules 
and Regulations Governing Allotments and Pay- 
ments to the States of Venereal Disease Funds pro- 
vide that: “All health departments or clinics re- 

ceiving funds shall provide facilities for (1) diag- 
nosis and emergency treatment of all patients who 
apply; (2) continued treatment, consultative , ad- 
vice or opinion for all patients referred by private 
physicians; and (3) continued treatment for all 
patients unable to afford private medical care. 

It is, therefore, sound public policy that diag- 
nostic services be freely available to any child who 
applies for services under the State crippled chil- 
dren’s program in order that the responsible public 
agency may determine the need for and extent of 
care required if the child is to have the best pos- 
sible physical restoration, emotional and social ad- 
justment and educational and work opportunities. 


THE PHYSICIAN’S ATTITUDE TOWARD 
THE EMIC PROGRAM 

It has been suggested that the attention of our 
readers be called to the address of Dr. E. D. Plass 
on The Physician’s Attitude Toward the Emergency 
Maternity and Infant Care (EMIC) Program, which 
he presented before the Annual Conference of Sec- 
retaries and Editors in Chicago November 17 and 
which was published in the January 13 issue of 
The Journal of the American Medical Association. 
It is regretted that because of paper restrictions we 
cannot publish this address by Dr. Plass as has been 
requested. 


CHANGE OF ADDRESS 

Help your central office to main- 
tain an accurate mailing list. 
Senid your changes of adiiress 
promptly to The Journal, 

505 Bankers Trust Bl<ig., 

Des Moines 9, Iowa. 


156 


Journal of Iowa State Medical Society 


April, 1945 


WOMAN^S AUXILIARY NEWS 

Mrs. Keith M. Chapler, Chairman of Press and Publicity Committee, Dexter, Iowa 

President — Mrs. Jay C. Decker, Sioux City 
President-Elect — Mrs. Soren S. Westly, Manly 
Secretary — Mrs. Allen C. Starry, Sioux City 
Treasurer — Mrs. Arthur E. Merkel, Des Moines 


AN AUXILIARY RESPONSIBILITY* 

Mrs. Eustace A. Allen 

First Vice-President and Chairman of Organization 

For any organization to survive there should be 
individual responsibility — a body of persons united 
for a specific purpose. One of the objects of our 
auxiliary is to increase friendlier relations between 
the families of physicians and between the medical 
profession and the laity. The measure of our success 
depends upon the unified and coordinated support of 
all members. It means cooperation and recognizing 
the rights of others. It is a direct appeal to the best 
that is in us and our fellowman. 

Today every organization realizes the need of post- 
war planning for the continuation of progress and 
improvement of mankind. Never has there been a 
time when cooperation was needed more than today. 
This is a time of interruptions and changes in the 
steady development of life toward a common con- 
sciousness and a common will. It is hoped that these 
changes will open man’s eyes to a fresh aspect of 
the possibility of a unified world, a world with one 
thought in mind — the outlawing of war. • This is not 
merely a moral and social revolution but a trend of 
the most obvious kind, the coordination of all nations 
of the world. 

One great purpose of this war is to change, to fuse 
and to enlarge all human life. This war has affected 
the life of everyone, some more than others. There 
will be more changes and adjustments necessary with 
the return of our armed forces to civilian life. We 
hope very shortly there will be coming back to every 
community the physicians who have served in the 
armed forces and with them their wives; some of 
whom have never been members of the auxiliary 
while others will be strangers to the locality. These 
wives have served as good soldiers themselves, in 
many instances breaking up their comfortable homes 
to be with their physician husbands as long as pos- 
sible or they have taken up defense work to aid in the 
war effort. We as the wives of those who have served 
on the homefront have a responsibility in upholding 
the ideals of our auxiliary. This can best be ac- 
complished by making this a year of personal service, 
by showing these prospective members sincere inter- 
est, friendliness and imparting to them the impor- 
tance and advantage of being an auxiliary member. 


Much help and cooperation can be given in seeing 
that they are comfortably located and also in intro- 
ducing them to the community. Let us show them 
that we are united in truth as well as in spirit for 
the purposes for which our auxiliary was founded. 

And last, gaining new friends is mining the rich- 
ness of life. It is the flowering of our own respect to 
be gracious to new opportunities and new acquaint- 
ances. We have different names, different environ- 
ments, different social experiences, but in our service 
to the medical profession and medical arts we may all 
be one and, together in this oneness, seek that fellow- 
ship which as gentlewomen we shall always welcome. 


LEADERSHIP AND VIGILANCE* 

War is the great changer of concepts. 

As though to compensate for the misery of those 
it touches War brings new viewpoints to the minds 
of men, opening their eyes to the needs of the society 
they serve and of which they are a part. Thus out 
of the chaos and agony of War is born social and eco- 
nomic progress for the peoples of the world. 

So it is with medical practice and the public de- 
mand for hospital and medical care in the United 
States. The problem of insuring medical care for 
those who need it most and are least able to bear the 
cost did not arise from the present War, but it has 
been brought into its sharpest focus during the past 
few years of the conflict. 

We of the Woman’s Auxiliary to the American 
Medical Association can be justly proud of the con- 
tribution being made by the leaders of organized 
medicine to the solution of this problem. Better 
national health must be the inevitable result of their 
efforts. 

In achieving this much desired goal, however, we 
must bend every effort to keep American medicine 
free and untrammeled, and as a body of intelligent 
women, reaching into every organization in our re- 
spective communities, molders of opinion, we have an 
extremely important role to play, a searching of our 
own hearts and minds to discover, if possible, what 
our relation to the current problem is today. 

Let us press on together in the great enterprise 
which the world knows as the American Medical 
Association, long since dedicated to freedom and 
(Continued on page 161) 


♦PVom the December, 1944, issue of “The Bulletin.** 


*From the December, 1944, issue of “The Bulletin/* 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


157 


History of Medicine in Iowa 

, Edited by the Historical Committee 

Dr. Walter L. Bierring, Des Moines, Chairman 
Dr. Henry G. Langworthy, Dubuque, Secretary Dr. John T. McClintock, Iowa City 

Dr. Murdoch Bannister, Ottumwa Dr. Frank E. Sampson, Creston 


Walter L. Bierring, M.D., Des Moines ' 


At the annual meeting of the Iowa State Medi- 
cal Society held in Creston April 17, 18, 19, 1895, 
the writer was privileged to present a paper en- 
titled “The Modern Treatment of Diphtheria With 
Demonstration of Method of Preparing Anti- 
toxin’’.* The original paper was based on the 
experience of preparing diphtheria antitoxin in 
the department of pathology and bacteriology at 
the University of Iowa during the winter of 1894- 
1895. 

This Avork was the result of study and observa- 
tion during the previous year at the Pasteur Insti- 
tute in Paris. In the year of 1894 the writer was 
privileged to observe the work of Dr. Emile Roux, 
Director of the Institute, and his associate. Dr. 
Martin, in the preparation of toxins of the bacillus 
diphtheriae, the immunization of horses, the proc- 
essing of antidiphtheritic serum, and the use of 
the same in the treatment of three hundred patients 
with diphtheria in the Children’s Hospital adjoin- 
ing the Institute. At the same time there was op- 
portunity to observe a similar number of diphtheria 
cases at the nearby Hospital Trousseau where the 
antidiphtheritic serum was not used. 

The effect of the new method of treatment at 
the Children’s Hospital was indicated by the drop 
in mortality rate from the average of the four pre- 
ceding years of 51.71 per cent to 25 per cent, while 
at the Hospital Trousseau where antidiphtheritic 
serum was not used, the mortality rate in 520 cases 
was 60 per cent, demonstrating at the same time 
the virulence of the prevailing epidemic. 

The diphtheria toxin necessary for immunization 
was prepared at the University Laboratory, inocu- 
lating with virulent diphtheria bacilli a series of 
Fernbach flasks containing bouillon culture media 
so arranged as to permit the passing of a constant 
current of moist air across the surface of the 
media, which greatly enhanced the production of 

♦Republished in the April, 1925, issue of the Journal of the 
Iowa State Medical Society. 


the toxins. After a three weeks’ growth the cul- 
tures were filtered through a Pasteur-Chamberland 
filter, the toxins being contained in the filtrate. 
The toxic strength was equivalent to 1 cc. pro- 
ducing death in a five pound rabbit in forty-eight 
hours. The immunization of the horse started 
with an injection of J4 cc. of the toxic filtrate 
which in the course of three months was gradually 
increased to 200 cc. When this stage of resistance 
or immunity was reached, the first tapping of blood 
was made from the jugular vein and the separated 
serum was found to- contain 300 to 500 immuniz- 
ing units in 20 cc. of serum. With repeated in- 
jections of toxin, the antitoxin content was gradu- 
ally increased to 1200 to 1500 units in 20 cc. of 
serum. The highest content produced at the Pas- 
teur Institute in Paris was 2000 units in 20 cc. of 
serum, and this was regarded as the largest dos- 
age necessary fifty years ago. The smaller doses 
of 300 to 500 units of the Iowa product were used 
as an immunizing and prophylactic agent, and the 
larger doses for therapeutic purpose. 

The antidiphtheritic serum prepared at Iowa 
City was used for both purposes in over 300 cases 
with favorable results and without untoward serum 
reactions. 

This was the first diphtheria antitoxin prepared 
west of New York City, and for a time its con- 
tinued production was considered, but it was not 
carried out because of the expense involved and 
the experienced personnel required. 

After the passage of the years, it will be inter- 
esting to recall the state of knowledge regarding 
diphtheria a half century ago, or at the beginning 
of a new era in the history of this disease. 

The clinical picture of the disease remains un- 
changed from the classical description by that fore- 
most French clinician of Tours who in 1826 with 
his Traite’ de la diphtherite gave it its name “diph- 
therie” and formed the basis of our knowledge of 
this later day. 


158 


Journal of Iowa State Medical Society 


His careful observations and epidemiologic stud- 
ies, during the succeeding four decades of the 
various clinical manifestations of diphtheria, clear- 
ly demonstrated its contagious nature, its transmis- 
sion from one person to another, and epidemic 
spread from one infectious focus, as well as its 
varying degrees of virulence. He established the 
unity of pharyngeal diphtheria (malignant angina ) 
and membranous croup or laryngeal diphtheria. 
His logical explanation of the termination of the 
disease and recovery therefrom in the human per- 
son was prophetic of the later knowledge regarding 
specific immunity and antitoxin production. 

The next significant contribution to the knowl- 
edge of diphtheria was its successful experimental 
transmission to animals by Oertel in 1871. The 
inoculation of material from the diphtheritic mem- 
brane to an ebraded mucus or cutaneous surface 
in mice, guinea pigs, rabbits, and pigeons resulted 
in the development of a pseudomemlirane at the 
point of inoculation, followed by systemic signs 
of illness and death ; the latter Oertel attributed 
to the absorption of a poisonous substance gener- 
ated at the site of the pseudomembrane. 

Perhaps the most important advance was the 
demonstration of the causative agent by Loeffler 
in 1884 in tbe form of a small rod-sbaped micro- 
organism termed tbe bacillus diphtheriae. While 
Klebs a year previously had demonstrated a sim- 
ilar microorganism, the specific relationship of the 
Loeffler bacillus to the disease diphtheria was es- 
tablished by its isolation in pure culture, inocula- 
tion into lower animals and resulting pseudo- 
membranous production and systemic symptoms 
with subsequent recovery of the bacillus and 
growth on culture media. 

The description by Loeffler of the characteristic 
appearance and rectangular arrangement of the 
bacillus diphtheriae in stained preparations, as 
well as the typical culture growth on blood serum 
agar media has formed the basis of bacteriologic 
diagnosis ever since. 

While Loeffler recognized the existence of a 
diphtheria toxin, it was the researches of Roux 
and Yersin published in the Annals of the Pasteur 
Institute in December 1888 that furnished the 
first clear description of the specific toxin produced 
by tbe diphtheria bacillus. The toxin production 
was increased with longer growth on special cul- 
ture media and the greater virulence of the diph- 
theria bacillus likewise augmented it. One cubic 
centimeter of the toxin solution was fatal to rabbits 
and guinea pigs, producing the characteristic sys- 
temic symptoms, even to the extent of the post- 
diphtheritic paralysis without the formation of a 
false membrane at the site of inoculation. These 


April, 1945 

studies really formed the basis of the ]>resent 
knowledge of bacterial toxins. 

In 1890 Behring, Kitasato, and Fraenkel an- 
nounced the discovery of dij)htheria antitoxin as 
contained in the blood serum of human persons 
and animals that had recovered from the disease. 
These German physicians further reported in 1892 
and 1893 the thera])eutic use of antidiphtheritic 
serum in experimental animals as well as in a 
moderate number of human cases with very favor- 
able results. Although antitoxic serum had not 
been definitely standardized at that time, it was a 
remarkalde advancement and no doubt .saved 
many lives. 

This first use of diphtheria antitoxin in a large 
number of diphtheria patients was at the Children’s 
Hospital, Pasteur Institute, Paris, which was re- 
ported by Doctors Roux and Martin in September 
1894. This report has been previously referred to. 
Later the Nobel prize in medicine was conferred 
jointly on Doctors Emile Roux and Emil von 
Behring for their eminent contributions to the 
knowledge and control of diphtheria. 

In 1895 the New York City Health Department 
under the supervision of Dr. William H. Park 
began to make, distribute, and administer anti- 
diphtberitic serum, and soon afterwards large scale 
production of diphtheria antitoxin was started by 
many pharmaceutic concerns. 

By means of various chemical concentrating and 
refining procedures it has been possible to remove 
and eliminate a large portion of the horse serum 
which contains the undesirable constituents. With 
this refined and purified material, the volume is 
smaller and consequently the serum reactions are 
reduced to a minimum. A dose of 10,000 units of 
diphtheria antitoxin cannot be obtained in as small 
a volume as 3 cc. 

The official unit for diphtheria antitoxin adopted 
in this country was established by M. J. Rosenau 
in 1905. A unit of antitoxin is defined as the 
smallest amount of antitoxin which will save the 
life of a 250 gram guinea pig when injected to- 
gether with a lethal dose of diphtheria toxin. 

Great changes have developed in the dosage of 
diphtheria antitoxin and its mode of administra- 
tion. Where a dosage of 1000 to 2000 units was 
regarded as sufficient fifty years ago, at the pres- 
ent time from 10,000 to 20,000 units are given in 
an ordinary case, while in a malignant case from 
60,000 to 100,000 are often administered. 

Antitoxin is now administered in three ways, 
intravenously, intramuscularly and subcutaneously. 
According to Park antitoxin diffuses ten times 
more rapidly when given intravenously than sub- 
cutaneously and four times more rapidly when 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


159 


given intramuscularly than when given subcu- 
taneously. In all laryngeal and other severe cases, 
the intravenous method is therefore indicated. 

The history of active immunization against 
diphtheria as applied to man is an interesting one. 
As early as 1892 Behring and Wernicke showed 
that susceptible animals might be safely immun- 
ized by inoculation with increasing doses of living 
diphtheria cultures after a protective dose of anti- 
toxin. 

In 1909 Theobald Smith immunized guinea pigs 
with a mixture of diphtheria toxin and antitoxin 
and suggested that it could be used as a practical 
means of immunizing children. 

Behring in 1913 was apparently the first actu- 
ally to immunize children against diphtheria with 
diphtheria toxin-antitoxin mixture. 

Distinct progress was made in the control of 
diphtheria when a simple method was found to 
determine susceptibility and means of producing 
active immunity. The Schick test was first de- 
scribed by Bela Schick in 1913. In the United 
States the test toxin for the Schick test is so stand- 
ardized that the amount injected intradermally, 
usually 0.1 cc., contains 1/50 of the minimal lethal 
dose of diphtheria toxin for a 250 gram guinea 
pig- 

In 1914 Park and Zingher of the New York 
City Department of Health used the Schick test 
and toxin-antitoxin on a large scale and thus pop- 
ularized its use in this country. This also marks 
the real beginning of diphtheria control, first in 
this country and later in other parts of the world. 

In 1924 Ramon was successful in detoxifying 
diphtheria toxin by the addition of small amounts 


of formalin and called the product anatoxin or 
toxoid. When it was found that toxoid would pro- 
duce a much higher immunity than toxin-antitoxin, 
the latter was soon displaced by toxoid. 

In 1926 Glenny and associates showed that the 
response to toxoid can be increased by delaying the 
absorption through precipitation of the toxoid with 
potassium alum. The delayed absorption leads 
to a slower excretion resulting in a prolonged anti- 
genic stimulation. 

From statistics here in Iowa and that of other 
state and city boards of health, it is shown that 
diphtheria has been largely controlled where a 
large number of children have been immunized 
with toxin-antitoxin, toxoid or alum precipitated 
toxoid. 

It is generally accepted that two doses of plain 
toxoid will give a higher immunity than three doses 
of toxin-antitoxin, and likewise that one dose of 
alum precipitated toxoid will give a greater anti- 
genic response than two doses of plain toxoid. 

The progress that has been made in the control 
of diphtheria during the past fifty years is re- 
markable. The facilities for such complete control 
are at hand, and are but to be used. 

That a large metropolitan area as New York City 
is diphtheria free, should be an example to the 
entire world. 

This article is written with the thought of its 
historical interest. By comparison it can be said 
that the fundamental principles governing the 
preparation, distribution, and therapeutic use of 
diphtheria antitoxin at the University of Iowa 
Medical School a half century ago essentially 
hold good today. 



Clyde A. Henry, M.D., Farson 
Part IV 

A COMPENDIUM OF WAPELLO COUNTY MEDICAL HISTORY FROM 1853 TO 1945 

(Continued from last month) 


Jefferson Wtllimnson was born in Adams 
county, Ohio, on March 31, 1827, and died Janu- 
ary 12, 1904, in Ottumwa. He received a good, 
common school education, and was a private 
student two years under Professor Robert Buck 
of West Union, Ohio. He studied medicine 
under Dr. H. G. Jones for two years and attended 
the Medical Department of the Western Reserve 
College at Cleveland, from which he received his 
medical degree in 1852. He married Miss Sarah 


N. Jones of Wilmington, Ohio, on May 27, 1852. 
They had one daughter by adoption, who married 
Mr. A. J. Colt on September 21, 1881. 

When the American Medical Association 
planned the centennial meeting which was held 
in Philadelphia, a request was made of the 
various state societies to prepare and present 
the medical histories of their respective states. 
In accordance with this request, a resolution was 
adopted by the Iowa State Medical Society in 


160 


Journal of Iowa State Medical Society 


1875 authorizing the President to appoint a com- 
mittee of five for this purpose. Subsequently, 
President Peck appointed Dr. J. Williamson 
chairman, with Drs. Middleton, McCulloch, Fair- 
child, and Thrall. 

At the next annual meeting of the State Society, 
January 27, 1876, Dr. Williamson, who as chair- 
man of the committee was to present to the 
centennial meeting at Philadelphia the Plistory 
of Medicine in Iowa, made a verbal report, stat- 
ing he had been unable to collect sufficient ma- 
terial from the doctors of the state to make a 
respectable record. He then tendered his resig- 
nation, which the Society reluctantly accepted : 
but, fortunately, Dr. D. S. Fairchild, then of 
Ames, was appointed in his steaji and Dr. J. J. M. 
Angear of Fort Madison was added to the com- 
mittee. Dr. Williamson was immediately ap- 
pointed chairman of the committee on publication 
which included Drs. A. G. Field, W. D. Middle- 
ton, S. B. Thrall, and J. W. Gustine. Thus was 
the beginning of recorded Medical History in 
Iowa. 

Dr. Williamson was vice president of the State 
Society in 1865, and president in 1873. He was 
also an officer of the International Medical Con- 
gress which was held in Washington, D. C., in 
September 1887. 

Dr. Williamson came to Ottumwa in November 
1852, and engaged at once in the practice of 
medicine. His cash income for the first year was 
less than one hundred dollars. His pioneer pa- 
tients had very little money. Consisting mostly 
of farm people, they settled their accounts with 
hay and grain for the horses, and butter and eggs 
and meat for his family. 

He was one of the founders of the Wapello 
County Medical Society, in 1853 ; assisted in the 
reorganization of the Society after the Civil War, 
in 1870, and was one of the founders of the Des 
Moines Valley Medical Association, in 1873, as- 
suming in each a responsibility greater than that 
of any other member for its successful develop- 
ment by serving each of them efficiently as sec- 
retary for many years. Nor should it be forgotten 
that he was one of a group of five physicians who 
so successfully established and directed the des- 
tinies of the public schools of Ottumwa for more 
than a quarter of a century. He was the author 
of many published articles, a valued contributor to 
the programs of the State Society, and was fre- 
quently called by various groups to discuss the 
medical problems of those days. He was also 
active for many years on committee assignments 
in the American Medical Association. 

Dr. Williamson was an accomplished scholar, 
a courteous gentleman and an outstanding leader 


April, 1945 

in both civic and professional affairs in the early 
days of Wapello county. 

Joseph Crawford Hinsey was born in Butler 
County, Ohio, June 9, 1829, and died April 9, 
1892, at his home in Ottumwa. Soon after his 
birth his parents, William and Mary Ilinsey, 
moved to Tazewell County, Illinois, and settled at 
an old Fort near which the city of Pekin now 
stands. His father died when he was eight years 
old. Although his mother married again, he re- 
mained with her family until he was fourteen 
years old, at which time he moved to Whiteside 
County, Illinois, to work for an uncle, Jonothan 
Haines. A contract was entered into, by the terms 
of which young Hinsey was to be allowed a certain 
amount of time for schooling while learning the 
trade of carpenter and joiner with his uncle. A^ 
to school, the terms of the contract were flagrantly 
violated ; and after helping his uncle construct and 
operate his first “Haines Harvester and Header,” 
of which he was inventor and patentee, the lad 
left his uncle to shift for himself at odd jobs in 
the neighborhood. After a few months he became 
an employee of Dr. A. Brown, who was a botanic 
doctor. Not only did young Hinsey have access to 
the doctor’s library, but he also assisted him in 
collecting the herbs and roots which were processed 
and manufactured into the pills he used. The boy 
was fascinated with his work, and soon contracted 
to stay with Dr. Brown for three years, with the 
understanding that he should be allowed money to 
attend a botanic medical college. When the first 
year of study had been completed, he entered an 
Eclectic Medical College, the Cincinnati Medical 
College, for one year. The third year was spent 
at the Ohio Medical College. Having completed 
his three years of stduy, he spent a short time in 
Whiteside County, and then, in the winter of 
1849, he returned to Pekin, Illinois, and entered 
the office of Drs. Fitch and Quigley, remaining 
with them for one year. He then entered Rush 
Medical College, Chicago, and graduated in the 
class of 1851. He returned to Pekin to begin his 
practice, and there married Miss Olive R. Upson 
in March, 1851. Two children resulted from this 
marriage, one dying in infancy. In August, 1853, 
death came to his wife. 

During the following winter. Dr. Hinsey at- 
tended a course of lectures at the Medical Depart- 
ment of the University of Pennsylvania, receiving 
therefrom the ad eundem degree of which he was 
justly proud. In the fall of 1854, he left Illinois 
on horseback and came to Iowa, hoping to im- 
prove his health which had become impaired from 
overwork and study. In due time, he arrived in 
the old town of Dahlonega, then a thriving village, 
almost as large as Ottumwa. He was favorably 


VoL. XXX\^ Xo. 4 


Journal of Iowa State Medical Society 


161 


impressed with the village people and the sur- 
rounding countryside, and at once engaged in the 
practice of medicine. When he arrived in Dahl- 
onega, he had $2.50 in money, and $40.00 in worth- 
less script. He remained in Dahlonega seven 
years, during which time he built up an extensive 
and successful practice. In the spring of 1862 he 
was appointed Surgeon of the Board of Enroll- 
ment with headquarters in Iowa City, but resigned 
in 1863, and moved to Ottumwa. He served one 
term as supervisor for Dahlonega township ; was 
county coroner four years, and was chairman of 
the convention that organized the Republican party 
in Wapello County in 1856. In 1856 he married 
Miss Louisa F. Lentner, of Dahlonega, who sur- 
vived him nine years. The two sons and eight 
daughters by this marriage reached mature years, 
but none of them aspired to a medical career. How- 
ever, a grandson, Joseph C. Hinsey, Jr., is follow- 
ing in the footsteps of his illustrious grandfather. 
He graduated from Northwestern University 
Medical School, Chicago, and Washington Uni- 
versity School of Medicine, St. Louis. After grad- 
uation, he returned to the medical staff at North- 
western University, and served there until called to 
Stanford University, Palo Alto, California, where 
he filled the Chair of Anatomy, and did extensive 
research work for six years. He was then called 
to Cornell University Medical College, New York, 
filling in turn the Chairs of Physiology and Anat- 
omy. He is now Dean of the School of Medicine. 

More than fifty years have passed since the 
death of Joseph Crawford Hinsey, but he is still 
remembered for his efficiency as a surgeon in the 
pre-antiseptic and pre-aseptic days of surgery in 
Iowa ; and to many of the older residents of Wap- 
ello County he will remain the highest ideal of an 
old time representative of medicine and surgery. 

(To be continued) 


ART CONTEST NOT CANCELED 

The art contest sponsored by Mead Johnson & 
Company on the subject of “Courage and Devotion 
Beyond the Call of Duty” (on the part of physicians) 
has not been canceled or postponed. The closing 
date remains May 27, 1946. 

There will be no annual exhibit this year of the 
American Physicians Art Association, due to the 
cancellation of the American Medical Association 
meeting which had been scheduled to take place in 
Philadelphia, June 18 to 22, 1945. 

For full details regarding the $34,000 prizes and 
the “Courage and Devotion” contest, write Dr. Fran- 
cis H. Redewill, Secretary, A. P. A. Association, 
Flood Building, San Francisco, California, or Mead 
Johnson & Company, Evansville, Indiana. 


WOMAN’S AUXILIARY NEWS 

(Continued from page 156) 

search for truth. Today it carries on its great tra- 
ditions. 

Cross currents among us for the moment may seem 
to tumble our bark about, but we sail in open waters 
with our compass handed to us by that splendid body 
of men, the American Medical Association. If we 
keep our prow ever toward that desirable harbor 
which they conceive, no wind of opinion can long 
carry us olf the course, for it is the set of the sail 
and not the gale that determines finally the direction 
in which we move. And we shall set sail in just one 
boat. — Mrs. Augustus S. Kbch 


THE LONG, LONG ROAD* 

“Hospital management was bad in the 17th century 
the world over. It was worse in the 18th. There 
was the same overcrowding, several patients occupy- 
ing one bed or pallet, the same absence of ventilation, 
the same presence of vermin and filth, the same lack 
of appreciation of the need for isolation of contagious 
diseases, the same misdirected effort at nursing, the 
same fatal issue following every attempt at major 
surgery. The mortality in the general hospitals of 
the period could not have been less than 20%. 

“The fearful mortality that accompanied hospital- 
ization in America at this time received further com- 
ment from Dr. Thatcher, who wrote, ‘It has been 
estimated that the loss of lives in the various armies 
of the United States during the war is not less than 
70,000. The number who died on the horrid prison 
ships of the enemy cannot be calculated. It is, how- 
ever, confidently asserted that no less than 11,000 of 
our brave soldiers died on board the one called Jersey 
Prison Ship only.’ 


“On April 15, 1708, the Council ordered ‘that a 
house be hyred for the accommodation of the sick men 
belonging to her Majesty’s Ship the Garland and that 
the Rent of the said house be paid out of her Majes- 
ty’s Revenue of two Shils per hogshead and it is rec- 
ommended to Collo William Wilson to provide a house 
accordingly.’ However, it was not until 1780 that 
steps were taken to establish a permanent marine 
hospital.” 

♦Quoted from "A Sketch of Medicine and Pharmacy” by S. E. 
Massengill, M.D. 


SPEAKERS BUREAU RADIO SCHEDULE 
WOI — Wednesdays at 2:45 p. m. 

WSUI — Thursdays at 9:00 a. m. 


April 4- 5 
April 11-12 
April 18-19 
April 25-26 


Cancer 

Allen C. Starry, M.D. 

Anesthesia 

Ralph E. Gray, M.D. 
Common Symptoms of Gallbladder 
Disease James A. Jacoby, M.D. 
Evacuation Hospital in Combat Area 
J. Philip Cogley, M.D. 


162 


Journal of Iowa State Medical Society 


April, 1945 


THE JOURNAL BOOK SHELF 


BOOKS R 

LIPPINCOTT’S QUICK REFERENCE BOOK FOR MEDICINE 
AND SURGERY, a Clinical, Diagnostic, and Therapeutic Di- 
gest of General Medicine, Surgery, and the Specialties, 
Compiled Systematically from Modern Literature — By George 
E. Rehberger, M.D. Twelfth edition. J. B. Lippincott Com- 
pany, Philadelphia, 1944. Price, $16.00. 

ATLAS OF THE BLOOD IN CHILDREN— By Kenneth D. Black- 
fan, M.D., Late Thomas Morgan Rotch Professor of Pedia- 
trics, Harvard Medical School, Late Physician-in-Chief, In- 
fants’ and Children’s Hospitals, Boston ; Louis K. Diamond, 
M.D., Assistant Professor of Pediatrics, Harvard Medical 
School, Visiting Physician and Hematologist, Infants’ and 
Children's Hospitals, Boston. With illustrations by C. Mm- 
BiLL LmsTER, M. D., Associate Pediatrician. St. Luke’s Hos- 
pital, Bethlehem and Allentown General Hospital, Allentown, 
Pennsylvania. The Commonwealth Fund, New York, 1944. 
Price, $12.00. ‘ 

ARTERIAL HYPERTENSION, Its Diagnosis and Treatment — By 
Irvine H. Page, M.D., and Arthur Curtis Corcoran, M.D., Re- 
search Division of the Cleveland Clinic Foundation, Cleveland, 
formerly Lilly Laboratory for Clinical Research, Indianapolis 
City Hospital, Indianapolis. The Year Book Publishers, Inc., 
Chicago, 1945. Price, $3.75. 

OPERATIONS OF GENERAL SURGERY— By Thomas G. Orr, 
M.D., Professor of Surgery, University of Kansas School of 
Medicine, Kansas City, Kansas. W. B. Saunders Company, 
Philadelphia. 1944. Price, $10.00. 


BOOK R 

PRINCIPLES AND PRACTICE OF SURGERY 

By W. Wayne Babcock, M.D., Emeritus 
Professor of Surgery, Temple University, 
Acting Consultant, Philadelphia General 
Hospital; with the collaboration of thirty- 
seven members of the faculty of Temple 
University. Lea & Febiger, Philadelphia, 

1944. Price, $12.00. 

This excellent book on the principles and practice 
of surgery is a classic text. The latest advances in 
surgery and surgical technic are presented in an 
understandable manner and interesting style. All 
branches of surgery are discussed and many detailed 
phases mentioned. 

The contents are divided into four categories: 
General Surgery, Surgical Technique, The Surgery 
of Systems, and Regional Surgery. 

It is the impression of the reviewer that this book 
will add much to the library of both the surgeon and 
the internist since it imbibes the most recent ad- 
vances not only in the technic of surgery but also in 
the treatment of patients. It is highly recommended. 

J. B. P. 


PATIENTS HAVE FAMILIES 

By Henry B. Richardson, M.D., Associate 
Professor of Clinical Medicine, Cornell Uni- 
versity Medical College; Attending Physi- 
cian, New York Hospital; Visiting Physi- 
cian, Bellevue Hospital. The Commonwealth 
Fund, New York, 1945. Price, S3. 00. 

Henry B. Richardson has added another contribu- 
tion to the list of books recently published which deal 


E C E I V E D 

MILITARY MEDICAL MANUALS, MANUAL OF CLINICAL 
MYCOLOGY — Prepared under the Auspices of the Division 
of Medical Sciences of the National Research Council. W. B. 
Saunders Company, Philadelphia, 1944. Price. $3.60. 

THE 1944 YE.$.R BOOK OF GENERAL SURGERY— Edited by 
Evarts A. Graham, M.D., Professor of Surgery, Washing- 
ton University School of Medicine ; Surgeon-in-Chief of the 
Barnes Hospital and of the Children’s Hospital, St. Louis. 
The Year Book Publishers, Inc., Chicago, 1944. Price, $3.00. 

SURGERY OF THE HAND— By Sterling Bunnell, M.D., honor- 
ary member of American Academy of Orthoptic Surgeons ; 
member of American Association of Plastic Surgeons and of 
American Society of Plastic and Reconstructive Surgery. 
J. B. Lippincott Company, Philadelphia, 1944. Price, $12.00. 

MEDICAL USES OF SOAP— Edited by Morris Fishbein, M.D. A 
symposium by Rudolf L. Baer, M.D., Irvin H. Blank, Ph.D., 
Theodore Cornbleet, M.D., Morris Fishbein, M.D., G. Thomas 
Halberstadt, B.S., Ch.E., Lester Hollander, M.D., Daniel J. 
Kooyman, Ph.D., C. Guy Lane, M.D., Carey McCord. M.D., 
Marion B. Sulzberger, M.D. J. B. Lippincott Company, Phila- 
delphia, 1945. Price, $3.00. 

THE ART OF RESUSCITATION— By Paluel J. Flagg, M.D., 
Chairman, Committee on Asphyxia, American Medical As- 
sociation ; President and Founder of the Society for the Pre- 
vention of Asphyxial Death, Inc. Reinhold Publishing Cor- 
poration, New York, 1944. Price, $5.00. 


E V I E W S 

with the mental phases of all sorts of illnesses. It 
approaches their psychosomatic aspects from the 
standpoint of the patient’s family. The author pre- 
sents a number of case histories which are of great 
interest to the reader because, in a sense, they depict 
an inter-family psychoneurotic reaction which might 
be likened to a neurosis contagion. The more we 
know of the influences which lead to nervous and 
mental instability, the better prepared we are to deal 
with them, individually and collectively. 

This book prompts us to think of the family as a 
culture medium upon which many noxious personal 
characteristics may grow. F. A. E. 


THE PATHOLOGY OF INTERNAL DISEASES 

By William Boyd, M.D., Professor of Pa- 
thology and Bacteriology in the University 
of Toronto, Toronto; formerly Professor of 
Pathology in the University of Manitoba, 
Winnipeg, Canada. Fourth edition, thor- 
oughly revised. Lea & Febiger, Philadel- 
phia, 1944. Price, SIO.OO. 

The stated objective of Boyd’s most scholarly text, 
“The Pathology of Internal Diseases,” is to present 
in a single volume the relations of anatomy, physiol- 
ogy and histology to the problems which confront 
every general practitioner. A discussion of the rela- 
tion of symptcnns to lesions concludes the discussion 
of every subject of major importance in the book. 
The book is, then, not an ordinary textbook of pathol- 
ogy; rather, it is a source of information about the 
fundamental processes of disease, intended more for 
the use of the clinician than of the medical student. 


VoL. XXXV, No. 4 


Journal of Iowa State Medical Society 


163 


This fourth edition, thoroughly revised with the 
addition of many new topics, is recommended without 
reservation by its reviewer. 

The author needs no recommendation. His several 
books have long been recognized as the most readable, 
usable works on pathology yet published. R. F. B. 


CLINICAL HEART DISEASE 
By. Samuel A. Levine, M.D., Assistant 
Professor of Medicine, Harvard Medical 
School; Physician, the Peter Bent Brigham 
Hospital, Boston; Consultant Cardiologist, 
Newton Hospital; Physician, New England 
Baptist Hospital, Boston. Third edition, re- 
vised and reset. W. B. Saunders Company, 
Philadelphia, 1945. Price, S6.00. 

The third edition of this practical work on cardiol- 
ogy maintains the same high standards established 
by the previous editions in presenting in a lucid form 
practical facts about the heart. 

The author persists in adhering to his principle 
of including only proved facts and does not attempt 
to cover all phases of the literature. More electro- 
cardiograms were added to illustrate clearly the 
points under discussion. In addition there is a brief 
discussion of phonocardiography, along with illus- 
trated sound records. The surgical treatment of pat- 
ent ductus arteriosus and the recent improvement 
in the treatment of subacute bacterial endocarditis, 
including the use of penicillin, have been amplified. 

This volume is an excellent desk reference for the 
busy practitioner. G. E. M. 


ANNUAL REPRINT OF THE REPORTS OF 
THE COUNCIL ON PHARMACY AND CHEM- 
ISTRY OF THE AMERICAN MEDICAL 
ASSOCIATION FOR 1943 
American Medical Association, Chicago, 
1944. Price, $1.00. 

The present volume of reprints contains only eight 
reports on rejected articles; it is interesting to note 
that objections to these are on a much higher plane 
than those it was necessary to urge against the 
flagrantly quackish preparations of earlier days. 

Perhaps the most noteworthy of the nineteen 
general and “status” reports in this volume is the 
one declaring the Council’s intention of using hence- 
forth only the metric or centimeter-gram-second 
system in its publications. The report itself gives 
some interesting and readable history on the sub- 
ject of weights and measures. Of most timely in- 
terest to the general physician as well as the endo- 
crine specialist is the report on nomenclature of 
endocrine preparations. The report gives a cur- 
rently quite complete list of the available com- 
mercial preparations, including those not accepted 
by the Council as well as those which stand accepted. 
Another report in the field of endocrinology is that 
recognizing the use of estrogens in the treatment of 
prostatic carcinoma. 

Attention should be called to at least two of the 
reports concerned with vitamin preparations, name- 


ly, the status report giving the Council’s decision 
that the evidence does not yet warrant the accept- 
ance of cod liver oil preparations for external use, 
and the report announcing the Council’s recognition 
of the use of massive doses of vitamin D in arthritis. 

The status report on xanthine compounds gives 
a much needed delimitation of the therapeutic 
claims that may be recognized for aminophylline 
and its related xanthine derivatives. Of similar 
interest is the report on the local use of sulfona- 
mides in dermatology, and in the same category 
may be mentioned the report on agents for the 
treatment of trichomonas vaginitis, which points 
out that the present aim should not be for new 
medicaments in this field but for further information, 
especially concerning failures with those that have 
been used. In another status report the Council 
sets forth its conclusion that present evidence does 
not justify claims for advantage of oral use of 
sodium sulfonamides over the free drug. 

In line with its decision to consider for acceptance 
various contraceptive preparations, the Council pub- 
lished a status report on conception control, which 
is concluded in this volume. The report comprises 
a series of concise statements on the various prep- 
arations and methods of control, prepared by Dr. 
Robert Latou Dickinson, together with a statement of 
criteria by which the Council will consider the accept- 
ability of contraceptive jellies, creams and syringe 
applicators and nozzles, diaphragms and caps. 


THE 1944 YEAR BOOK OF PEDIATRICS 
Edited by Isaac A. Abt, M.D., Professor 
of Pediatrics, Northwestern University Med- 
ical School; with the collaboration of Arthur 
F. Abt, M.D., Comdr., M.C., U.S.N.R., Asso- 
ciate Professor of Pediatrics, Northwest- 
ern University Medical School. The Year 
Book Publishers, Chicago, 1945. Price, 
$3.00. 

Review of any of the Year Book series in a med- 
ical journal is scarcely necessary since it is incon- 
ceivable that there is any physician who is not al- 
ready thoroughly aware of the service performed 
by these little but valuable volumes. The 1944 
book on pediatrics is essentially an abstract of the 
world’s pediatric literature by those two top-notch, 
nationally known pediatricians — Dr. Isaac Abt and 
his son, Arthur. Thus the reader can be assured 
that a careful selection of ai’ticles has been made 
and the abstracting done in such a way that the 
full meat of the original article is presented. 

What has been written on some twenty-two pe- 
diatric subjects by various authors has been brought 
together in abstract form in this 427 page book. 
Author, title, and publication are given for each 
article so that the reader may readily refer to 
the original if he so desires. As a saver of time, 
and as a means of keeping informed in the most 
recent developments in the pediatric field, this book 
is highly recommended. It should be owned by 
every physician who deals with children. 

L. F. H. 


164 


[oi-RNAL OF Iowa State Medical Society 


April, 1945 


SOCIETY PROCEEDINGS 


Hlack Hawk County 

A dinner meeting of the Black Hawk County Med- 
ical Society was held in Waterloo at Black’s Tea 
Boom Tuesday, March 20, at 6:30 p. m. Major 
Edward L. Rohlf, M.C., of Waterloo, who is home 
on emergency leave after serving thirty-two months 
in the Mediterranean and European theaters of 
war, was the guest of honor and told of his ex- 
periences in this war. 

H. A. Bender, M.D., President 

Johnson County, 

The regular meeting of the Johnson County Med- 
ical Society was held in Iowa City at Hotel Jeffer- 
son Wednesday, March 7, at 6:00 p. m. The guest 
speaker of the evening was A. Earl Walker, M.D., 
Professor of Neurosurgery at the University of 
Chicago, who presented an illustrated lecture on The 
Syndrome of Cerebral Concussion. Discussion of 
the paper was led by A. L. Sahs, M.D., of the De- 
partment of Neurology and W. R. Miller, M.D., of 
the Department of Psychiatry at the State Uni- 
versity of Iowa College of Medicine. 

R. H. Flocks, M.D., Secretary 

Page County 

Members of the Page County Medical Society met 
at the Municipal Hospital in Clarinda Thursday, 
March 1, at 6:30 p. m. Guest speakers were Charles 
P. Baker, M.D., and Eugene E. Simmons, M.D., of 
Omaha, Nebraska. Several physicians residing out- 
side of Page County were also in attendance. 

J. F. Aldrich, M.D., Secretary 

Scott County 

The March meeting of the Scott County Medical 
Society was held in Davenport at the Lend-A-Hand 
Club Tuesday evening, March 6. Following dinner, 
Robert A. Hayne, M.D., Chief of the Division of 
Neurosurgery, Department of Surgery, State Uni- 
versity of Iowa College of Medicine, spoke on Com- 
mon Neurologic Disturbances. 

L. J. Miltner, M.D., Secretary 


Tama County 

Members of the Tama County Medical Society 
held a meeting Thursday evening, March 1, at the 
American Legion Hall in Toledo. Dinner was served 
hy the American Legion Auxiliary. 


. Wapello County 

April meetings of the Wapello County Medical 
Society will be held April 3 and April 17 at St. 
Joseph Hospital in Ottumwa. On April 3 Harold 
A. Spilman, M.D., of Ottumwa will present a scien- 
tific film entitled Diagnosis and Treatment of In- 


fections of the Hand. A business meeting is sched- 
uled for April 17. 


Washington County 

The Washington County Medical Society met 
Thursday evening, March 8, for an oyster supper. 
John W. Dulin, M.D., Associate Professor of Sur- 
gery at the State University of Iowa College of 
Medicine, was the guest speaker of the evening. The 
subject of his address was Appendicitis. 

W. S. Kyle, M.D., Secretary 


PERSONAL MENTION 

Lt. Col. Dennis H. Kelly has returned to Des Moines 
and at present is on terminal leave after thirty-one 
months of active duty in the Army Medical Corps, 
most of which time was spent as Executive Officer 
of Fitzsimons General Hospital in Denver. The 
Journal is indeed happy to have Dr. Kelly resume 
his position of Associate Editor. 


Dr. David A. Herron, who has practiced in Alta 
for the past twenty-nine years, has moved to Iowa 
Falls where he has taken over the practice and equip- 
ment of the late Dr. Bert E. Purcell, eye, ear, nose 
and throat specialist. 


DEATH NOTICES 

Daly, James Joseph, of Decorah, aged seventy-five, 
died February 20 of a heart attack. He was gradu- 
ated in 1898 from Northwestern University Med- 
ical School, and at the time of his death was a life 
member of the Winneshiek County and Iowa State 
Medical Societies. 


Hasek, Victor Hugo, of Cedar Rapids, aged fifty- 
three, died February 25 after a brief illness. He 
was graduated in 1916 from the University of Illi- 
nois College of Medicine, and at the time of his 
death was a member of the Linn County and Iowa 
State Medical Societies. 


Thomson, John Allen, of Soux City, aged sixty- 
five, died February 28 following a cerebral hemor- 
rhage. He was graduated in 1904 from the Sioux 
City College of Medicine, and at the time of his 
death was a member of the Woodbury County and 
Iowa State Medical Societies. 


Walker, Claude Martin, of Kellerton, aged seventy- 
one, died March 2 after an illness of several months. 
He was graduated in 1898 from the St. Louis College 
of Physicians and Surgeons, and at the time of his 
death was a member of the Ringgold County and 
Iowa State Medical Societies. 


The JOURNAL 


Iowa State Medical Society 


VoL. XXXV 


Des Moines, Iowa, May, 1945 


No. 5 


ONE MAN’S OPINION 

]\I. C. Hennessy, M.D., President 
Iowa State Medical Society 

I have asked for the privilege of addressing this 
organization with the hope of selling to you a 
few ideas of mine, and solely with the thought in 
mind of increasing the efficiency of our organi- 
zation and of keeping it modernized. The obser- 
vations and suggestions I am about to make have 
been formulated during the period of my activi- 
ties over a number of years as an official in vari- 
ous capacities in the State Society. I have served 
on various committees of both the House of Dele- 
gates and the Council, having been a member of 
the Council for ten years, two of which were in 
the capacity of chairman. I have also served as 
a member of the Board of Trustees, as president- 
elect for one year, and am now finishing my term 
as president. 

REPORTS BY PRESIDENT AND PRESIDENT-ELECT 

As I have attended the meetings of the House 
of Delegates, I have always felt there is one thing 
that is striking by its absence, and that is that the 
president never has, nor is he required to present 
to the House of Delegates his viewpoints and rec- 
ommendations for the good of the Society. I 
hope that my discussion will result in the House 
of Delegates making it a mandatory duty of the 
president to present to it his views and opinions 
on the workings of the State Society, for its con- 
sideration and action. No man could have served 
in the various capacities, and as president, with- 
out having developed some fixed ideas of condi- 
tions which could be improved, or of others that 
should be eliminated, or something added which 
may be of service to the Society ; and at the pres- 
ent time there is no exact method by which the 
president can do this, except through the various 
committees. But these committees have certain 
functions and some of the ideas generated by the 

Presented before the House of Delegates, Iowa State Medical 
Society, Des Moines, April 18, 1945. 


president, based on his experience, cannot feas- 
ibly be presented. Because of this situation, it is 
my opinion that the president should be required 
to make an annual report to the House of Dele- 
gates, and that the same opportunity be given the 
incoming president so that he may indicate what 
he hopes to accomplish during his term of office. 

STRUCTURE OF THE HOUSE OF DELEGATES 

The biggest surprise I ever received as an offi- 
cer of this organization was the fact 'that I, as an 
elected official along with all the other elected 
officials, was an automatic member of the House 
of Delegates. I never could understand, from my 
first meeting up to the present day, why that 
should be, and I have repeatedly, over the years, 
questioned the sagacity of such a structure. It 
has never appeared to be democratic to me. The 
elected group of officials can always control the 
vote in the House of Delegates, if they are so 
minded. If you should ask me if this has ever 
taken place, I would frankly answer, “Never to 
my knowledge.” Please remember that these offi- 
cials are only human beings, however, and cer- 
tainly when actions, of which they have approved 
during the interim between meetings of the House 
of Delegates, are presented to the House for its 
approval or rejection, it is not likely that they 
will vote disapproval. This style of membership 
of the House of Delegates is a continuous, open 
invitation to a few high-pressure politicians to 
take over the affairs of the State Medical Society 
and, in my opinion, the Constitution should be 
altered to read that the House of Delegates shall 
consist of the duly elected delegates of the com- 
ponent county societies, together with the presi- 
dent and the secretary, and that the voting power 
be solely in the hands of the delegates, with the 
president voting only in case of a tie, and that 
the other elected officials be required to be pres- 
ent at each meeting of the House of Delegates to 
furnish any information required, but with no 
voting privileges. 


166 


Joi'KNAL OF Iowa State Medical Society 


May, 1945 


SPEAKERS BUREAU 

Some years back the Society authorized the 
formation of the Speakers Bureau. This was an 
idea engendered with the thought of keeping our 
memhersliip well informed on medical topics, sci- 
entific and otherwise. I approved of that thought 
and I still do. However, T do believe that this 
has resulted in some harm to both the State 
Society and its component county societies. The 
programs furnished by the Speakers Bureau have 
been of the highest type, so much so that they have 
interfered with the meetings of the smaller county 
societies, and I feel have hurt the county socie- 
ties, and indirectly, the State Society. The fact 
that this councilor district, or that councilor dis- 
trict, is putting on a six to eight week refresher 
course results in the societies in that area not 
holding their own county meetings, and with the 
further result that the members of those societies 
lose interest in their own society. This failure 
to have county meetings discourages the members 
in preparing papers for programs and stifles their 
desires to appear as essayists. Any time the State 
Society fosters anything which will destroy a 
county society it is fostering its own doom. We 
must never lose sight of one fact, and that is that 
the county society is the foundation upon which 
our State Society is built. It is my opinion, there- 
fore, that it is imperative the Society restudy 
and redefine the duties of the Speakers Bureau 
in an endeavor to maintain its good, and at the 
same time protect the interest of each county 
society. As a suggestion along this line, it is 
my opinion that the host society should be re- 
quired to provide at least one essayist for the pro- 
gram, and that each society be required to act as 
host for at least one meeting sponsored by its 
district. 

DELEGATES TO THE AMERICAN MEDICAL 
ASSOCIATION 

The Iowa State Medical Society is entitled to 
three delegates to the American Medical Associa- 
tion. I have studied the Journal of the Iowa 
State Medical Society and the Handbook of 
the State Society, covering a period of years. In 
most of those years there has been no report in 
the Journal of the delegates who attended the 
annual session of the American Medical Associa- 
tion, and the first official notice we in Iowa have 
received was in the Handbook of the annual meetr 
ing, which as you know is issued shortly before 
the annual meeting. This, to me, can result in the 
Iowa Society not being fully informed as to the 
contemplated projects of the American Medical 
Association, and surely we should know, as one 
of the component societies, what is going on. Cer- 


tainly the president should be informed, so that 
during tlie course of his term he can at least direct 
some of the efforts of the State Society, either 
in approving or rejecting the proposals of the 
American Medical Association. With this thought 
in mind, it is my opinion that the incoming presi- 
dent of the State Society automatically should 
become one of the delegates to the American Med- 
ical Association, and that it be mandatory for each 
delegate to furnish a report of the meeting, with- 
in sixty days of the session, for publication within 
ninety days in the Journal of the Iowa State 
AIedical Society. 

CENSORSHIP 

At the present time there is no internal dissen- 
sion which requires any censorship action by the 
State Society. In recent years there were two 
such cases, involving the affairs of two of our 
county societies. There seemed to be no proper 
manner in which to dispose of these cases. In 
one, however, the members of the county society, 
meeting with the Council, finally straightened out 
their difficulties to the satisfaction of the member- 
ship of their county society and also of the Coun- 
cil. This was not made possible by any particu- 
lar rules, but merely by the fact that the mem- 
bers of the county society involved essentially 
straightened out the situation themselves. In the 
other case, time and death cured the situation. 
Waiting for death to make decisions for an or- 
ganization of our type is scarcely a laudable pro- 
cedure, and it would seem to me that it now is 
time for this organization to study and enact the 
necessary legislation to handle any such cases in 
the future. 

These suggestions are made, not necessarily 
with the thought that you will accept them in toto, 
but with the thought that whether you reject or 
accept the ideas advanced they will at least merit 
your consideration. So far, it would seem as if 
I have nothing to do or offer other than criticism. 
That thought is far from the fact. 

EXECUTIVE council 

It is this man’s opinion that the finest action 
taken by the State Society was the authorization 
of the formation of the Executive Council to act 
and assume the powers of the House of Delegates 
between meetings of the House. Each year the 
Executive Council is proving more valuable than 
I believe was anyone’s fondest expectation. I am 
sure it has engendered in your officers a feeling 
of authoritativeness which they did not have be- 
fore. In other words, they do not have the feel- 
ing that maybe their efforts will be of no avail; 
and I am of the opinion that over the years it will 
prove to be more valuable than it has to date. 


VoL. XXXV, No. 5 


Journal of Iowa State Medical Society 


167 


RELATIONSHIP BETWEEN THE STATE SOCIETY AND 
THE COLLEGE OF MED